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Organization

JOHN L. ROUSSALIS M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN LOUIS ROUSSALIS M.D. (PRESIDENT)
(307) 234-4585
Entity
Organization

Contact information

Practice address
1129 E 2ND ST, CASPER, WY 82601-2903
(307) 234-4585
(307) 265-7479
Mailing address
1129 E 2ND ST, CASPER, WY 82601-2903
(307) 234-4585
(307) 265-7479

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
7691A
WY

Other

Enumeration date
10/22/2007
Last updated
09/07/2011
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