RUSSELL W BRETHAUER

Dr RUSSELL W BRETHAUER is a male medical professional, specializing in Psychologist, Clinical. He graduated in 1981.

Contact

700 PILGRIM PKWY
SUITE L9
ELM GROVE
WI
531222063

Tel: 2627855557

RUSSELL W BRETHAUER Information

Npi 1023062528
Pac Id 8426159435
Professional Enrollment Id I20070720000459
Last Name BRETHAUER
First Name RUSSELL
Middle Name W
Suffix
Gender M
Credential
Medical School Name OTHER
Graduation Year 1981
Primary Specialty PSYCHOLOGIST, CLINICAL
Secondary Specialty 1
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Secondary Specialty 3
Secondary Specialty 4
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Organization Legal Name
Group Practice Pac Id
Number Of Group Practice Members
Line 1 Street Address 700 PILGRIM PKWY
Line 2 Street Address SUITE L9
Marker Of Address Line 2 Suppression
City ELM GROVE
State WI
Zip Code 531222063
Phone Number 2627855557
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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