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Individual

DR. DOMINIC A RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1265 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512-4004
(330) 758-9400
(330) 726-8676
Mailing address
1265 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512-4004
(330) 758-9400
(330) 726-8676

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2330
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0460246
OH
Enumeration date
07/19/2005
Last updated
05/17/2011
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