Individual
MR. TODD HAROLD BRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, CSCS, PA-C
Contact information
Practice address
1110 KEPLER DR, GREEN BAY, WI 54311-8306
(920) 288-5555
(920) 288-5550
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
350-039
WI
363A00000X
Physician Assistant
Primary
3058
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417178443
—
WI
Enumeration date
05/01/2007
Last updated
04/21/2026
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