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1710345483
RUSSELL JOHNSON
MILWAUKEE, WI
NPI
1710345483
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WI 4642)
Enumeration Date
2016-02-09
Last Update Date
2021-12-06
Business Address
RUSSELL JOHNSON
2801 W KINNICKINNIC RIVER PKWY STE 370
MILWAUKEE, WI 53215-3678
Phone number: 414-649-7900
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Mailing Address
RUSSELL JOHNSON
2801 W KINNICKINNIC RIVER PKWY STE 370
MILWAUKEE, WI 53215-3678
Phone number: 414-649-7900
Copy
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