| Doctor Name: | ALEXANDRA DENISE RUSSELL |
| NPI Number: | 1922399849 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 2010031805 |
| Business Practice Address: | 225 Physicians Park Suite 101 Poplar Bluff, MO - 639013956 |
| Business Phone Number: | 5737789348 |
| Business Fax Number: | 5736864870 |
| Mailing Address: | 2725 N Westwood Blvd, Suite 17 POPLAR BLUFF |
| State: | MO |
| Postal Code: | 639012346 |
| Phone Number: | 5737789348 |
| Fax Number: | 5736864870 |
| NPI Enumeration Date: | 04/26/2011 |
| NPI Last Update Date: | 08/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2010031805 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| 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 |