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Individual

ANTONINO RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
871 OLD ALICE RD STE 600, BROWNSVILLE, TX 78520-8274
(956) 541-2102
Mailing address
871 OLD ALICE RD STE 600, BROWNSVILLE, TX 78520-8274
(956) 541-2102

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1124782
TX

Other

Enumeration date
09/19/2012
Last updated
09/19/2012
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