MICHELLE JEAN RUSSELL

GLENDALE, WI
NPI1225315849
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: WI  11860-24)
Enumeration Date2011-11-10
Last Update Date2014-03-13
Business Address
-- MICHELLE JEAN RUSSELL DPT
5538 N SHASTA DR
GLENDALE, WI 53209-4925
Phone number: 920-540-8626
Mailing Address
-- MICHELLE JEAN RUSSELL DPT
5538 N SHASTA DR
GLENDALE, WI 53209-4925
Phone number: 920-540-8626
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