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1366096729
RUSSELL EIDE
MINNEAPOLIS, MN
NPI
1366096729
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: 1164184)
Enumeration Date
2019-07-24
Last Update Date
2019-07-24
Business Address
RUSSELL EIDE PA-C
3300 OAKDALE AVE N
MINNEAPOLIS, MN 55422-2926
Phone number: 763-520-5200
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Mailing Address
RUSSELL EIDE PA-C
2986 S SUPERIOR ST
MILWAUKEE, WI 53207-2544
Phone number: 715-308-4563
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