DR. Ty D Russell, D.C.

NPI #1487961322 in Gravette, Arkansas

Provider Information

NPI Number: 1487961322
Entity Type: Individual
Name: DR. Ty D Russell, D.C.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Credential: D.C.
Enumeration Date: Sep 13, 2010
Last Updated: Sep 17, 2014

Practice Location

Address: 207 ATLANTA STREET S.E.
City: Gravette
State: Arkansas
ZIP Code: 72736
Phone: (479) 787-7555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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Organizations

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