Individual
MR. KARL JOSEPH RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
901 W ASHLAND AVE, GLENOLDEN, PA 19036-1101
(610) 461-6522
Mailing address
901 W ASHLAND AVE, GLENOLDEN, PA 19036-1101
(610) 461-6522
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE007568
PA
Other
Enumeration date
01/27/2015
Last updated
01/28/2015
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