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Individual

RUTHANN RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
2006 ROUTE 71, SUITE 2, SPRING LAKE, NJ 07762-2273
(484) 357-7899
Mailing address
205 1ST AVE, SPRING LAKE, NJ 07762-1004
(484) 357-7899

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25-004854
NY
171100000X
Acupuncturist
25MZ93300
NJ

Other

Enumeration date
09/10/2013
Last updated
09/10/2013
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