Antonino Roberto Russo, | |
1945 Hiland Ave, Burley, ID 83318-2714 | |
(208) 647-0024 | |
Not Available |
Full Name | Antonino Roberto Russo |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 3 Years |
Location | 1945 Hiland Ave, Burley, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316604937 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT-7636 (Idaho) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wright Physical Therapy Limited Partnership | 1759612641 | 54 |
Provider Name | Wright Physical Therapy Limited Partnership |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1730732025 PECOS PAC ID: 1759612641 Enrollment ID: O20191007003583 |
Mailing Address | Practice Location Address |
---|---|
Antonino Roberto Russo, 1411 Falls Ave E Ste 401, Twin Falls, ID 83301-3455 Ph: (208) 647-0024 | Antonino Roberto Russo, 1945 Hiland Ave, Burley, ID 83318-2714 Ph: (208) 647-0024 |
Dr. Tyler Carlen, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1501 Hiland Ave, Burley, ID 83318 Phone: 208-677-6530 | |
Nicholas Lewis, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1945 Hiland Ave, Burley, ID 83318 Phone: 208-647-0024 Fax: 208-647-0239 | |
Austin Stoddard, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1263 Bennett Ave Ste 2, Burley, ID 83318 Phone: 208-678-1191 | |
Mr. Jeffrey Dwain Manion, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 933 Sandy Glen Ln, Burley, ID 83318 Phone: 402-290-4584 | |
Ryan Patrick Mccormick, P.T., D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1945 Hiland Ave, Burley, ID 83318 Phone: 208-647-0024 Fax: 208-647-0239 | |
Troy Michael Anderson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1501 Hiland Ave, Burley, ID 83318 Phone: 208-677-6530 |