Individual
SIMONE FRANK RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 E DESERT INN RD, SUITE 108, LAS VEGAS, NV 89121-3619
(702) 369-2628
(702) 792-4328
Mailing address
2428 SABADO ST, LAS VEGAS, NV 89121-4125
(702) 792-4077
(702) 991-8044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4511
NV
Other
Enumeration date
11/22/2006
Last updated
07/08/2007
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