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Kelsey Russo
NPI 1467993626 · on the registry since 2017 · sole proprietor
Practice
- Address
- 2362 Tanglewood Lane
Lake Ariel, PA 18436 - Phone
- (570) 862-8842
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 2255A2300X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2017-03-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania