Organization
RUSSELL W MASTERSON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL MASTERSON PHD (OWNER)
(239) 513-6013
Entity
Organization
Contact information
Practice address
15395 ROYAL FERN LN W, NAPLES, FL 34110
(239) 513-6013
Mailing address
PO BOX 111600, NAPLES, FL 34108-0127
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY2435
FL
Other
Enumeration date
10/31/2006
Last updated
07/16/2008
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