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

CARISSA LEIGH RUSSELL, ATC

Active Sole Proprietor

CARISSA LEIGH RUSSELL, ATC is a Athletic Trainer healthcare provider located in MILLBURY, Ohio. NPI 1568082923 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · MILLBURY, OH

Registration Details

NPI Number
1568082923
Provider Type
Individual
Gender
Female
NPI Issued
Apr 25, 2020 (6.3116359278164 yrs)
Last Updated
Apr 25, 2020
Sole Proprietor
Yes

Practice Information

Address
28080 LEMOYNE RD
MILLBURY, OH, 434479747
Browse OH providers · Browse ZIP 43447
Phone
4192793794
Primary Specialty
Athletic Trainer
2255A2300X
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.