Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angelina Russo

Individual provider Physical Therapist · NPI 1326872722

Angelina Russo is a Physical Therapist in Private Practice in Jackson, Wyoming. Qualified in 2024, 2 years ago. Practices with Excel Physical Therapy LLC, a 9-clinician group and accepts Medicare assignment. Licensed in Wyoming.

Years since qualifying
2
Licensed in
WY
In the registry since
2024
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

120 W Pearl Ave
Jackson, WY 83001-8657
Phone: (307) 734-9129
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT-2435 (WY)

Record details

NPI number1326872722
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 28, 2024
Last updated in NPPESAugust 28, 2024
Certification dateAugust 28, 2024
Mailing address230 E Broadway Apt 609, Salt Lake City, UT 84111-2441

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Excel Physical Therapy Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jackson