Provider Demographics
NPI:1184230823
Name:CURL, RUSSELL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:
Last Name:CURL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12011 CITRUS FALLS CIR APT 302
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5716
Mailing Address - Country:US
Mailing Address - Phone:248-860-0749
Mailing Address - Fax:
Practice Address - Street 1:12011 CITRUS FALLS CIR APT 302
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5716
Practice Address - Country:US
Practice Address - Phone:248-860-0749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5655225100000X
FLPT35949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist