Individual provider · Type 1 NPI

Anthony J. Russo, PTA

Physical Therapy Assistant · Orange Park, FL

NPI number 1861990657 Active

Practice location

2300 Park Ave Ste 203
Orange Park, FL 32073-5573

Fax (904) 634-0203

Mailing address

6500 Bowden Rd Ste 103
Jacksonville, FL 32216-8066

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XPTA28155 (FL)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1861990657

Anthony J. Russo, PTA's National Provider Identifier is 1861990657, issued on Jan 26, 2018. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Orange Park, FL. The record was last updated on Jan 26, 2018.