Individual
WHITNEY RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 MAIN ST, SUITE 1D, STRATFORD, CT 06614-4946
(203) 378-0092
(203) 375-4540
Mailing address
12 DOGWOOD DR, EASTON, CT 06612-2213
(076) 574-5982
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9519
CT
Other
Enumeration date
09/18/2012
Last updated
04/06/2018
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