| Doctor Name: | MR. KEVIN T RUSSELL |
| NPI Number: | 1881601318 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BS, MSPT |
| License Number: | 4359 |
| Business Practice Address: | 111 Goose Lane Ste 2500 Guilford, CT - 06437 |
| Business Phone Number: | 2034530134 |
| Business Fax Number: | 2034530167 |
| Mailing Address: | 111 Goose Lane, Suite 2500 GUILFORD |
| State: | CT |
| Postal Code: | 06437 |
| Phone Number: | 2034530134 |
| Fax Number: | 2034530167 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 03/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 4359 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| 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 |