Search › Georgia › 207XX0005X
Zachary Russell, ATC, LAT, CSCS, OTC
NPI 1750753182 · on the registry since 2015 · sole proprietor
Practice
- Address
- 1305 Jennings Mill Road
Building 300, Suite 110
Watkinsville, GA 30677 - Phone
- (706) 613-5880
- Fax
- (706) 613-5880
- Organisation at this address
- Wellstreet Of Georgia Pc
Piedmont Athens Regional Medical Center IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 62
Additional practice sites
- 2200 Bonforte Blvd, Pueblo, CO
Registry record
- Primary taxonomy
- 207XX0005X
207XX0005X
- Also registered as
- 390200000X
- Licence states on file
- CO, GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-09-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia