ANTONINO ROBERTO RUSSO

BURLEY, ID
NPI1316604937
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-7636)
Enumeration Date2021-11-18
Last Update Date2021-11-18
Business Address
ANTONINO ROBERTO RUSSO
1945 HILAND AVE
BURLEY, ID 83318-2714
Phone number: 208-647-0024
Mailing Address
ANTONINO ROBERTO RUSSO
1411 FALLS AVE E STE 401
TWIN FALLS, ID 83301-3455
Phone number: 208-647-0024
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