Russell, Ida Alicia
Russell, Ida Alicia is an individual health care provider with primary practice located at 424 N University Ave , Little Rock AR 72205-3109. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Russell, Ida Alicia can be contacted via phone (501) 661-0336.Contact Information
Primary practice address
424 N University Ave
Little Rock AR 72205-3109
Phone: (501) 661-0336
Fax: (501) 661-0412
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 293 | Arkansas |
Profile Details
| NPI number | 1700841038 |
|---|---|
| LBN Legal business name | Russell, Ida Alicia |
| Credentials | Athletic Trainer, Certified (ATC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
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