Individual
MRS. KIMBERLY MURO RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-8484
(215) 707-3946
Mailing address
907 MCKEAN ST, PHILADELPHIA, PA 19148-2326
(267) 247-6013
(215) 707-9131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA057504
PA
Other
Enumeration date
07/14/2015
Last updated
10/28/2021
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