Organization
MARK V RUSSO, DC, LLC
Active
Other names
RUSSO CHIROPRACTIC AND REHAB CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARK VINCENT RUSSO D.C (OWNER)
(973) 344-0129
Entity
Organization
Contact information
Practice address
157 LAFAYETTE ST, NEWARK, NJ 07105-1439
(973) 344-0129
(973) 344-0243
Mailing address
157 LAFAYETTE ST, NEWARK, NJ 07105-1439
(973) 344-0129
(973) 344-0243
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MCOO235500
NJ
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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