Individual
DR. ANDREW THOMAS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2101 BOWEN ST, OSHKOSH, WI 54901-2013
(920) 303-5006
Mailing address
2101 BOWEN ST, OSHKOSH, WI 54901-2013
(920) 303-5006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17586-40
WI
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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