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1669400024
RUSSELL ALAN BERGUM
ROCHESTER, MN
NPI
1669400024
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207QS0010X Family Medicine, Sports Medicine
(Licence: MN 42602)
Enumeration Date
2006-06-28
Last Update Date
2023-08-16
Business Address
RUSSELL ALAN BERGUM D.O.
2560 2ND ST SW STE 120
ROCHESTER, MN 55902-4363
Phone number: 507-361-0400
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Mailing Address
RUSSELL ALAN BERGUM D.O.
2560 2ND ST SW STE 120
ROCHESTER, MN 55902-4363
Phone number: 507-361-0400
Copy
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