Russell, Elizabeth Diane
Russell, Elizabeth Diane is an individual health care provider with primary practice located at 5407 Union Sq , Benton AR 72019-6898. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Russell, Elizabeth Diane can be contacted via phone (205) 394-0120.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 3111 | Arkansas |
Profile Details
| NPI number | 1609994813 |
|---|---|
| LBN Legal business name | Russell, Elizabeth Diane |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 26th, 2007 |
| Last updated | Nov 29th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609994813 | NPPES |
| Arkansas | MEDICAID | 184220721 |
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