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1285267617
MITCHELL RUSSO
SAN DIEGO, CA
NPI
1285267617
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA 297093)
Enumeration Date
2020-02-13
Last Update Date
2020-02-13
Business Address
MITCHELL RUSSO DPT
15004 INNOVATION DR
SAN DIEGO, CA 92128-3491
Phone number: 858-605-7189
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Mailing Address
MITCHELL RUSSO DPT
10790 RANCHO BERNARDO RD MAIL DROP 4S-205 IN ADDRESS 2 BOX
SAN DIEGO, CA 92127
Phone number:
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