Individual
SEAN MICHAEL DERUSSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1198 SMILEY AVE STE F, CINCINNATI, OH 45240-1866
(513) 671-6362
Mailing address
4440 EASTWOOD DR APT 10311, BATAVIA, OH 45103-4414
(513) 405-1051
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA013768
OH
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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