Individual
DAN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2770
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11148-24
WI
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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