Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MARK WILLIAM RUSSELL, P.T.A.
Active Sole ProprietorMR. MARK WILLIAM RUSSELL, P.T.A. is a Community Health Worker healthcare provider located in EDENTON, North Carolina. NPI 1437314366 is currently active in the NPPES registry. Verify at CMS.
Community Health Worker · EDENTON, NC
Registration Details
- NPI Number
- 1437314366
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 21, 2008 (18.111490480626 yrs)
- Last Updated
- Jul 21, 2008
- License
-
3666 (NC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
108 SCHOONER LANDING DREDENTON, NC, 279328833Browse NC providers · Browse ZIP 27932
- Phone
- 2526324137
- Primary Specialty
-
Community Health Worker
172V00000X
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.