Jacob A Russell

NPI #1881300861 in Belle Fourche, South Dakota

Provider Information

NPI Number: 1881300861
Entity Type: Individual
Name: Jacob A Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: Jan 24, 2023
Last Updated: Jan 24, 2023

Practice Location

Address: 2200 13TH AVE
City: Belle Fourche
State: South Dakota
ZIP Code: 57717-2215
Phone: (605) 892-3331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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