Individual
DR. AMANDA B RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
285 TERRY RD, SAYVILLE, NY 11782-3343
(631) 563-2225
Mailing address
285 TERRY RD, SAYVILLE, NY 11782-3343
(631) 563-2225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X011982-1
NY
Other
Enumeration date
01/24/2011
Last updated
10/24/2012
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