Individual
ANTHONY RUSSOMANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1311 EMERSON CT, AMBLER, PA 19002-1552
(215) 237-0622
Mailing address
1311 EMERSON CT, AMBLER, PA 19002-1552
(215) 237-0622
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
1220842320
PA
Other
Enumeration date
12/14/2024
Last updated
12/14/2024
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