Heather Carroll Russell, PT

Individual provider Active NPI Physical Therapist · Ruckersville, VA

NPI 1093022014 · NPPES record last updated Sep 13, 2010

Key facts

NPI
1093022014
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2305006648 (VA)
Practice address
1029 W Daffodil Rd
Ruckersville, VA 22968-2403
Phone
(434) 985-1081
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2305006648VAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305006648 VA Yes

Addresses

Primary practice location

1029 W Daffodil Rd
Ruckersville, VA 22968-2403

Mailing address

1029 W Daffodil Rd
Ruckersville, VA 22968-2403
Phone (434) 985-1081

Other providers in Ruckersville, VA

All providers in Ruckersville, VA · Physical Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.