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Contact Information

MICHAEL D RUSSELL, PT,DPT, CSCS
129 W LAKE MEAD PKWY
SUITE 2
HENDERSON, NV89015-6954
 Phone: 702-564-6712
 Fax: 702-564-4838
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MICHAEL D RUSSELL · (Male)

NPI Number 1003012980
Status Active
Credentials PT,DPT, CSCS
Entity Individual
Enumeration date 06/26/2007
Last updated 05/04/2012 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NV License # 2143
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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