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1780623561
DIANE RUSSO
ANCHORAGE, AK
NPI
1780623561
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: AK 100)
Enumeration Date
2006-06-06
Last Update Date
2007-07-08
Business Address
-- DIANE RUSSO
4201 TUDOR CENTRE DR SUITE 320
ANCHORAGE, AK 99508-5904
Phone number: 907-729-4955
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Mailing Address
-- DIANE RUSSO
1800 E PARKS HWY
WASILLA, AK 99654-7353
Phone number: 907-729-6000
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