Individual
MR. RUSSELL ROBERT SOBOTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH., MBA
Contact information
Practice address
N83W15550 APPLETON AVE, MENOMONEE FALLS, WI 53051-3714
(262) 253-5056
Mailing address
5560 W LAKE DRIVE, WEST BEND, WI 53095
(414) 507-5635
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10276
WI
Other
Enumeration date
12/15/2020
Last updated
12/17/2020
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