Individual ProviderCarolyn Elaine Russell-CanaanPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address516 N Rolling Rd, Ste 302, Catonsville, MD 21228-4140(410) 744-1666(800) 793-5464PECOS EnrollmentBased on the most recent information from CMS, provider Carolyn Elaine Russell-Canaan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1578875563Provider TypeIndividualFull NameRussell-Canaan, Carolyn ElaineCredentialD.P.T.GenderFemaleSole ProprietorNoEnumeration Date7/8/2010Last Updated5/10/2017Contact InformationPractice LocationPractice Address516 N Rolling Rd, Ste 302, Catonsville, MD 21228-4140Phone(410) 744-1666Fax(410) 788-9755Mailing LocationMailing Address3179 Braverton St, Ste 201, Edgewater, MD 21037-2667Phone(800) 793-5464Fax(267) 321-2099Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense23328Maryland