Individual
CHLOE LAN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3747 ROSWELL RD STE 205, MARIETTA, GA 30062-6227
(470) 956-9050
(678) 560-4339
Mailing address
377 ROSWELL ST NE STE 205, MARIETTA, GA 30060
(470) 956-9050
(678) 560-4339
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
76158
GA
208000000X
Pediatrics Physician
76158
GA
Other
Enumeration date
03/27/2013
Last updated
10/31/2019
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