Individual provider · Type 1 NPI

Russell Fornator, CCP

Specialist · Phoenix, AZ

NPI number 1033247481 Active

Practice location

10930 N Tatum Blvd, #103
Phoenix, AZ 85028-6069

Call (602) 263-7600 Map

Fax (602) 212-0365

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1033247481

Russell Fornator, CCP's National Provider Identifier is 1033247481, issued on Feb 28, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 8, 2007.