Individual
KELLY A RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, NCS, ATP
Contact information
Practice address
414 PAOLI PIKE, MALVERN, PA 19355-3311
(484) 596-7894
Mailing address
82 TUCKER DR, DOWNINGTOWN, PA 19335-1457
(443) 739-6993
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
—
PA
Other
Enumeration date
11/29/2006
Last updated
01/18/2019
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