Individual
MICHAEL RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, FAAOMPT
Contact information
Practice address
29800 BAINBRIDGE RD # SO40, SOLON, OH 44139-2202
(440) 914-8603
Mailing address
29800 BAINBRIDGE RD # SO40, SOLON, OH 44139-2202
(440) 914-8603
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
014662
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014662
014662
OH
Enumeration date
03/26/2020
Last updated
03/26/2020
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