Individual
ANNI RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2160 SANDY DR, STE A, STATE COLLEGE, PA 16803-2282
(814) 861-8122
(814) 861-4292
Mailing address
2160 SANDY DR, STE A, STATE COLLEGE, PA 16803-2282
(814) 861-8122
(814) 861-4292
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT018198
PA
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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