Russo, Michael

Russo, Michael is an individual health care provider with primary practice located at 400 W Main St , Branford CT 06405-3416. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Russo, Michael can be contacted via phone (203) 483-7778.

Contact Information

Primary practice address
400 W Main St Branford CT 06405-3416
Phone: (203) 483-7778
Fax: (203) 481-0234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 000561 Connecticut

Profile Details

NPI number 1891762837
LBN Legal business name Russo, Michael
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Jan 19th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891762837 NPPES
Connecticut Other 000561 STATE LICENSE

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