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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. RUSSELL ALLEN FANNING, PTA

Active Sole Proprietor

MR. RUSSELL ALLEN FANNING, PTA is a Occupational Therapist healthcare provider located in HYDRO, Oklahoma. NPI 1356556955 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · HYDRO, OK

Registration Details

NPI Number
1356556955
Provider Type
Individual
Gender
Male
NPI Issued
May 14, 2007 (19.106981938316 yrs)
Last Updated
Jul 8, 2007
License
1498 (OK)
Sole Proprietor
Yes

Practice Information

Address
800 N. ARAPAHO
HYDRO, OK, 73048
Browse OK providers · Browse ZIP 73048
Phone
4056632335
Primary Specialty
Occupational Therapist
225200000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.