Angela Landon Russell, PT | |
9830 Harbor Master Blvd, Ocean City, MD 21842-9381 | |
(410) 713-2216 | |
Not Available |
Full Name | Angela Landon Russell |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 9830 Harbor Master Blvd, Ocean City, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669798328 | NPI | - | NPPES |
435138000 | Medicaid | MD | |
216538 | Other | MD | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 18674 (Maryland) | Primary |
Provider Name | Aquaworx |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1912204983 PECOS PAC ID: 4082891759 Enrollment ID: O20110606000477 |
Mailing Address | Practice Location Address |
---|---|
Angela Landon Russell, PT 9830 Harbor Master Blvd, Ocean City, MD 21842-9381 Ph: (410) 713-2216 | Angela Landon Russell, PT 9830 Harbor Master Blvd, Ocean City, MD 21842-9381 Ph: (410) 713-2216 |
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