Individual
MRS. PAULA PETRULLO RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
207 E 5TH AVE, RANSON, WV 25438-1613
(304) 728-5051
(304) 728-9735
Mailing address
6568 FLOWING SPRINGS RD, SHENANDOAH JUNCTION, WV 25442-4666
(304) 876-3626
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00382
WV
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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