Individual
MEGAN RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 WATER MILL RD, BLUFFTON, SC 29909-7304
(908) 217-6114
Mailing address
5 WATER MILL RD, BLUFFTON, SC 29909-7304
(908) 217-6114
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/04/2022
Last updated
01/11/2024
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