| Doctor Name: | ELIZABETH DIANE RUSSELL |
| NPI Number: | 1609994813 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 3111 |
| Business Practice Address: | 5407 Union Sq Benton, AR - 720196898 |
| Business Phone Number: | 2053940120 |
| Business Fax Number: | |
| Mailing Address: | 5407 Union Sq, BENTON |
| State: | AR |
| Postal Code: | 720196898 |
| Phone Number: | 2053940120 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 11/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 3111 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| 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 |