Mr. Edward John Russell III, COTAL
Mr. Edward John Russell III, COTAL is an Occupational Therapy Assistant in Mesa, Arizona. Practices as a sole proprietor. Licensed in Arizona.
- Licensed in
- AZ
- In the registry since
- 2014
Practice location Address checks out
5358 E Baseline RdMesa, AZ 85206-4716
Phone: (480) 630-3005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Occupational Therapy Assistant (primary) | Taxonomy 224Z00000X · Licence 5776 (AZ) |
|---|
Record details
| NPI number | 1730599226 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | COTAL |
| Sole proprietor | Yes |
| NPI enumerated | May 6, 2014 |
| Last updated in NPPES | May 6, 2014 |
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