Russell Kenworthy, ATC
NPI #1417362559 in Long Beach, Mississippi
Provider Information
- NPI Number
- 1417362559
- Entity Type
- Individual
- Name
- Russell Kenworthy, ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Jun 27, 2014
- Last Updated
- Jun 27, 2014
Practice Location
- Address
- 312 RITA LN
- City
- Long Beach
- State
- Mississippi
- ZIP Code
- 39560-4338
- Phone
- (228) 234-4959
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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