DIAMOND KATINA RUSSOS

CHARLOTTE, NC
NPI1811467137
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NC  0010-08718)
Enumeration Date2018-11-29
Last Update Date2024-07-15
Business Address
DIAMOND KATINA RUSSOS PA
1001 BLYTHE BLVD STE 500
CHARLOTTE, NC 28203-5866
Phone number: 704-373-1813
Mailing Address
DIAMOND KATINA RUSSOS PA
PO BOX 19305
CHARLOTTE, NC 28219-9305
Phone number:
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