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1407989445
MATTHEW THOMAS RUSSELL
YORKTOWN HEIGHTS, NY
NPI
1407989445
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: NY 001809-1)
Enumeration Date
2007-03-13
Last Update Date
2007-07-08
Business Address
Mr. MATTHEW THOMAS RUSSELL PTA
3535 HILL BLVD SUITE P
YORKTOWN HEIGHTS, NY 10598-1293
Phone number: 914-962-2728
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Mailing Address
Mr. MATTHEW THOMAS RUSSELL PTA
PO BOX 673
GOSHEN, NY 10924-0673
Phone number: 845-294-5065
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