Individual
MR. JOSHUA DANIEL RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3623 LATROBE DR, SUITE 216, CHARLOTTE, NC 28211-4864
(704) 332-1291
(704) 332-5206
Mailing address
PO BOX 221249, CHARLOTTE, NC 28222-1249
(704) 332-1291
(704) 332-5206
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/03/2013
Last updated
01/28/2014
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