| Doctor Name: | LAVERNE RUSSELL |
| NPI Number: | 1114057031 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT OTR |
| License Number: | PT 000526 E |
| Business Practice Address: | 101 E State St Kennett Square, PA - 193483109 |
| Business Phone Number: | 6109254545 |
| Business Fax Number: | 6109254579 |
| Mailing Address: | 560 Riverview Rd, SWARTHMORE |
| State: | PA |
| Postal Code: | 190811020 |
| Phone Number: | 6105431460 |
| Fax Number: | 6105417923 |
| NPI Enumeration Date: | 03/07/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 000526 E |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |