Doctor Name: | GEORGE RUSSELL |
NPI Number: | 1922493055 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PTL0012394 |
Business Practice Address: | 12961 Lafayette St Unit H Thornton, CO - 802413969 |
Business Phone Number: | 7205083422 |
Business Fax Number: | |
Mailing Address: | 12961 Lafayette St Unit H, THORNTON |
State: | CO |
Postal Code: | 802413969 |
Phone Number: | 7205083422 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2015 |
NPI Last Update Date: | 04/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PTL0012394 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
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 |