Ida Alicia Russell in Benton - Athletic Trainer
Ida Alicia Russell - NPI 1700841038
Ida Alicia Russell is a Athletic Trainer in Benton, Arkansas. Ida Alicia Russell practices all healthcare services and medical treatments related to Athletic Trainer. The NPI Number for Ida Alicia Russell is 1700841038. The last update date is 2007-07-08.
Ida Alicia Russell's current location address is 3408 Silica Heights Rd, Benton, Arkansas. You can contact this provider via phone number 5018606601. The mailing address for Ida Alicia Russell is 3408 Silica Heights Rd, Benton, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ida Alicia Russell |
|---|---|
| Address | 3408 Silica Heights Rd, Benton, Arkansas |
| Phone Number | 5018606601 |
| Fax Number | |
| Sole Proprietor | X |
| Credentials | ATC |
NPI Number Detail
| NPI Number | 1700841038 |
|---|---|
| Provider Enumeration Date | 2006-04-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3408 Silica Heights Rd |
|---|---|
| City | Benton |
| State | Arkansas (AR) |
| Post Code | 720155622 |
| Phone Number | 5018606601 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Athletic Trainer |
|---|---|
| Taxonomy | 2255A2300X |
| Licence No | 293 |
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Definition: Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-leve |
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What is the unique 10-digit identifier code assigned to Ida Alicia Russell by the Centers for Medicare & Medicaid Services?
The Ida Alicia Russell has been issued the NPI (National Provider Identifier) 1700841038 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Ida Alicia Russell?
The Ida Alicia Russell is physically situated at 3408 Silica Heights Rd, in the city of Benton, state of AR, with the postal code 720155622.
What is the Ida Alicia Russell's specialty and taxonomy code?
The Ida Alicia Russell's specialty is Athletic Trainer, and the corresponding taxonomy code is 2255A2300X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1700841038 to Ida Alicia Russell?
The Centers for Medicare & Medicaid Services originally issued the 1700841038 to Ida Alicia Russell on 2006-04-19.
As of what date were the details pertaining to Ida Alicia Russell last refreshed?
The information related to the Ida Alicia Russell, including its address, specialty, and other relevant details, was last updated on 2007-07-08.