Individual
ANNE RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1800 N BROAD ST, PEARSON HALL 264, PHILADELPHIA, PA 19121-3302
(215) 204-0264
Mailing address
1800 N BROAD ST, PEARSON HALL 264, PHILADELPHIA, PA 19121-3302
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000151
PA
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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