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Individual

MICHAEL J RUSSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
20301 SW ACACIA ST STE 150, NEWPORT BEACH, CA 92660-1741
(949) 274-9551
(949) 264-8219
Mailing address
20301 SW ACACIA ST STE 150, NEWPORT BEACH, CA 92660-1741
(949) 274-9551
(949) 264-8219

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
34635
CA

Other

Enumeration date
01/18/2011
Last updated
03/27/2020
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