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1033453212
RUSSEL WAYNE UNDERWOOD
HENRICO, VA
NPI
1033453212
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: VA 2305207625)
Enumeration Date
2012-11-12
Last Update Date
2012-11-12
Business Address
-- RUSSEL WAYNE UNDERWOOD PT, DPT
1523 SPLIT OAK LN APT H
HENRICO, VA 23229-5295
Phone number: 804-288-2052
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Mailing Address
-- RUSSEL WAYNE UNDERWOOD PT, DPT
1523 SPLIT OAK LN APT H
HENRICO, VA 23229-5295
Phone number: 804-288-2052
Copy
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