Individual
CHAD RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHAMD
Contact information
Practice address
1101 FRESNO ST, FRESNO, CA 93706-3235
(559) 441-0998
(559) 441-1088
Mailing address
6035 W PINEDALE AVE, FRESNO, CA 93722-2600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
47195
CA
Other
Enumeration date
03/19/2011
Last updated
03/19/2011
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