Individual
RUSTY BURRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
1901 CONNECTICUT AVE S, SARTELL, MN 56377
(320) 259-4100
(320) 259-8044
Mailing address
1901 CONNECTICUT AVE S, SARTELL, MN 56377
(320) 259-4100
(320) 259-8044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9618
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046650600
—
MN
Enumeration date
06/22/2006
Last updated
07/20/2010
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