Individual
SANTO A RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
275 BEATTY DR, BELMONT, NC 28012-2715
(704) 512-3391
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-4645
(704) 355-4231
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2315
NC
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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