Provider Demographics
NPI:1891982203
Name:RUSSELL, EMILY FRANCES (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:FRANCES
Last Name:RUSSELL
Suffix:
Gender:F
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 1:111 BREWSTER ST
Mailing Address - Street 2:ND PHYSICAL THERAPY
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4400
Mailing Address - Country:US
Mailing Address - Phone:401-729-3481
Mailing Address - Fax:401-729-3866
Practice Address - Street 1:111 BREWSTER ST
Practice Address - Street 2:ND PHYSICAL THERAPY
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4400
Practice Address - Country:US
Practice Address - Phone:401-729-3481
Practice Address - Fax:401-729-3866
Is Sole Proprietor?:No
Enumeration Date:2007-09-29
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22262225100000X
RI02150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist