Provider Demographics
NPI:1669511028
Name:BIGGERS, RUSSELL S (DPT)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:S
Last Name:BIGGERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7471 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2457
Mailing Address - Country:US
Mailing Address - Phone:559-436-6228
Mailing Address - Fax:559-436-0500
Practice Address - Street 1:2021 HERNDON AVE
Practice Address - Street 2:STE. 102
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6101
Practice Address - Country:US
Practice Address - Phone:559-321-8405
Practice Address - Fax:559-900-7952
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 23854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT 23854OtherPHYSICAL THERAPY LICENCE