Individual
MR. RUSSELL RAYESKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3805 W GLENWOOD DR, FRANKLIN, WI 53132-8433
(414) 761-9652
Mailing address
3805 W GLENWOOD DR, FRANKLIN, WI 53132-8433
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1193-019
WI
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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