IndividualActive
Andrew Russo, ATC, SCAT
NPI 1013376649 · Athletic Trainer · Charleston, SC
Provider details
- NPI number
- 1013376649
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC, SCAT
- Sex
- Male
- Sole proprietor
- No
Mailing address
1620 Poincare Bnd
Virginia Beach, VA 23454-6926
Registry dates
- Enumerated
- 2016-02-10
- Last updated
- 2018-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.