Individual
MICHELLE RUSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
490 BLUE HILL AVE., HARTFORD, CT 06112
(860) 714-3420
Mailing address
490 BLUE HILL AVE., HARTFORD, CT 06112
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000490
CT
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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