NPI 1013376649

Andrew Peter Russo, ATCSCAT

Practitioner Athletic Trainer Charleston, SC

Practice location

Address: 301 Meeting St, Charleston, SC 29424-1552
Phone: (757) 635-9512
Mailing address: 1620 Poincare Bnd, Virginia Beach, VA 23454-6926

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 2043 (SC)

Other Specialist/Technologist providers in South Carolina →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in South Carolina →

Registry record

NPI: 1013376649
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Feb 2016
Record last updated: 8 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.