Individual
MRS. COLLEEN E RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., P.T.
Contact information
Practice address
556 KITCHINGS DR, STATESVILLE, NC 28677-3588
(704) 872-0024
Mailing address
PO BOX 1845, STATESVILLE, NC 28687-1845
(704) 873-4277
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P13684
NC
225100000X
Physical Therapist
PT 24193
FL
Other
Enumeration date
10/14/2008
Last updated
11/12/2024
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