Individual
MR. CHRISTOPHER JAMES RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2401 PLOVER RD, PLOVER, WI 54467-3916
(715) 295-3800
Mailing address
2401 PLOVER RD, PLOVER, WI 54467-3916
(715) 295-3800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1584023
WI
Other
Enumeration date
08/01/2006
Last updated
04/01/2021
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