KASSIE RUSSOM

CHARLESTON, SC
NPI1194315572
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: SC  3982)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2021-01-20
Last Update Date2022-07-11
Business Address
KASSIE RUSSOM PA-C
316 CALHOUN ST
CHARLESTON, SC 29401-1113
Phone number: 843-724-2450
Mailing Address
KASSIE RUSSOM PA-C
PO BOX 751649
CHARLOTTE, NC 28275-1649
Phone number: 843-789-1620
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