NPI 1366562712

Karen Michele Varisco-Russell, PTA

Practitioner Physical Therapy Assistant Fayetteville, GA

Practice location

Address: 1255 Highway 54 W, Fayetteville, GA 30214-4526
Phone: (770) 719-7183
Mailing address: 136 Maple Hill Dr, Newnan, GA 30265-5580

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA001748 (GA)

Other Physical Therapy Assistant providers in Georgia →

Registry record

NPI: 1366562712
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.