| NPI | 1669409488 |
|---|---|
| Former Name | VANESSA M RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT014314) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 014518) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2021-08-26 |