Individual
DR. MARK VINCENT RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
310 MOUNTAIN AVE, NORTH CALDWELL, NJ 07006-4013
(973) 725-4836
Mailing address
310 MOUNTAIN AVE, NORTH CALDWELL, NJ 07006-4013
(973) 725-4836
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00235500
NJ
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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