Individual
LIANA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
172 E MERRITT ST STE C, PRESCOTT, AZ 86301-2027
(928) 642-5382
Mailing address
172 E MERRITT ST STE C, PRESCOTT, AZ 86301-2027
(267) 886-3382
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
LAC-011371
AZ
171100000X
Acupuncturist
OM000212
PA
Other
Enumeration date
05/18/2016
Last updated
07/30/2024
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