Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 50471-020 | WI |
NPI | 1053385104 |
---|---|
Provider Name | Dr. Rusty Christopher Brand |
First Address | Rochester, MN 55905-0001 |
Second Address | Eau Claire, WI 54702-1510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 30/10/2020 |