| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JEFF RUSS | 1023627023 | 2020-07-24 |
Jeff Russ is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1023627023. Registration indicates Jeff Russ is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapist (Physical Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Jeff Russ PT |
| Practice Office Address | 1300 ALBANY ST BEECH GROVE, IN US |
| Practice Office Telephone | 3177827200 |
| Mailing Address | 3200 COLD SPRING RD APT 220 INDIANAPOLIS, IN 462221960 US |
| Business Telephone | 3173615293 |
| Code | Practice | License No State |
|---|---|---|
| 225100000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist Physical Therapist Speech/Occupational/Physical Therapy/Chiropractor Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 05009096A
IN |