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 code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1201X | Technician/Technologist, Optometric Assistant | 2474 | AZ | Yes |
Practice location
1650 W Valencia RdTucson, AZ 85746-6021
Phone 520-573-3264 · Fax 520-294-2686
Mailing address
1650 W Valencia RdTucson, AZ 85746-6021
Phone 520-573-3264 · Fax 520-294-2686
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