Michele Renae Russell, D.P.T.

NPI #1699343558 in Lakeside, Arizona

Provider Information

NPI Number: 1699343558
Entity Type: Individual
Name: Michele Renae Russell, D.P.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: D.P.T.
Enumeration Date: Jun 16, 2021
Last Updated: Apr 21, 2022

Practice Location

Address: 4830 HIGHWAY 260 STE 105
City: Lakeside
State: Arizona
ZIP Code: 85929-5851
Phone: (928) 532-1221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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