BRIANA RUSSOM

ROCKFORD, IL
NPI1558661702
Former NameBRIANA VANBRIESEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: IL  085003897)
Enumeration Date2010-10-21
Last Update Date2021-02-19
Business Address
BRIANA RUSSOM PA-C
2473 MCFARLAND RD
ROCKFORD, IL 61107
Phone number: 779-696-9202
Mailing Address
BRIANA RUSSOM PA-C
PO BOX 7866
MILWAUKEE, WI 53278-8866
Phone number: 779-696-7150
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