Individual
MR. RUSSEL RAYMOND PELOQUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
17 MULLER RD, WATERLOO, WI 53594-9515
(920) 623-0516
Mailing address
17 MULLER RD, WATERLOO, WI 53594-9515
(920) 623-0516
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
WI
Other
Enumeration date
12/09/2006
Last updated
07/08/2007
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