MARY RUSSO

PUEBLO, CO
NPI1023421864
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: CO  DR.0058320)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: MI  5101021285)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI  5101021285)
Enumeration Date2014-06-10
Last Update Date2022-07-21
Business Address
-- MARY RUSSO DO
400 W 16TH ST
PUEBLO, CO 81003-2745
Phone number: 719-584-4306
Mailing Address
-- MARY RUSSO DO
400 W 16TH ST
PUEBLO, CO 81003-2745
Phone number: 719-584-4306