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1295336956
RYAN RUSSO
SAN DIEGO, CA
NPI
1295336956
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
364S00000X Clinical Nurse Specialist
(Licence: CA 4605)
Enumeration Date
2020-11-07
Last Update Date
2020-11-07
Business Address
RYAN RUSSO
2376 SOTO ST
SAN DIEGO, CA 92107-1410
Phone number: 414-803-6018
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Mailing Address
RYAN RUSSO
2376 SOTO ST
SAN DIEGO, CA 92107-1410
Phone number: 414-803-6018
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