Individual
PATRICIA A RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
2958 INGRAM AVE, MELBOURNE, IA 50162-9559
(641) 750-7185
Mailing address
2958 INGRAM AVE, MELBOURNE, IA 50162-9559
(641) 750-7185
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00749
IA
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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