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Organization
TOWER AQUATIC, LLC
Active
Organization
TOWER AQUATIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD RUSSO JR. (CEO)
(617) 926-4800
Entity
Organization
Contact information
Practice address
290 CITRUS TOWER BLVD STE 108, CLERMONT, FL 34711-2783
(352) 242-9022
(352) 242-9044
Mailing address
PO BOX 15746, CINCINNATI, OH 45215-0746
(513) 522-4600
(513) 672-2143
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
10/03/2022
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