Laura Lynn Russo, D.C.
Chiropractor in Suwanee, GA. Individual provider (NPI-1).
NPI number1124072038
StatusActive
Last updated in NPPESFeb 12, 2021
Details
- NPI
- 1124072038
- Entity type
- Individual (NPI-1)
- Name
- Ms. Laura Lynn Russo
- Credential
- D.C.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 22, 2006
- Certification date
- Feb 12, 2021
- Last updated
- Feb 12, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | CHIR008176 | GA | Yes |
Practice location
525 Peachtree Industrial Blvd Ste DSuwanee, GA 30024-4071
Phone 770-831-7556 · Fax 770-831-7928
Mailing address
525 Peachtree Industrial Blvd Ste DSuwanee, GA 30024-4071
Phone 770-831-7556 · Fax 770-831-7928
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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