Individual provider · NPI-1

Russell Alan Damico, LDO

Technician/Technologist, Optometric Assistant · Tucson, AZ

NPI number1386447589
StatusActive
Last updated in NPPESMar 31, 2025

Details

NPI
1386447589
Entity type
Individual (NPI-1)
Name
Russell Alan Damico
Credential
LDO
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 31, 2025
Certification date
Mar 31, 2025
Last updated
Mar 31, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1201X Technician/Technologist, Optometric Assistant2474AZYes

Practice location

1650 W Valencia Rd
Tucson, AZ 85746-6021

Phone 520-573-3264 · Fax 520-294-2686

Mailing address

1650 W Valencia Rd
Tucson, AZ 85746-6021

Phone 520-573-3264 · Fax 520-294-2686

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.

Other Technician/Technologist, Optometric Assistant providers in Tucson, AZ