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1245058072
GRACE JEWELL RUSSO
DURHAM, NC
NPI
1245058072
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NC P22248)
Enumeration Date
2024-10-01
Last Update Date
2024-10-01
Business Address
GRACE JEWELL RUSSO PT, DPT
1821 HILLANDALE RD STE 25B
DURHAM, NC 27705-2671
Phone number: 919-660-6628
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Mailing Address
GRACE JEWELL RUSSO PT, DPT
811 148TH CT NE
BRADENTON, FL 34212-5601
Phone number: 816-654-4708
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