Russell Donald De Lap, ATC

NPI #1104969336 in Mequon, Wisconsin

Provider Information

NPI Number
1104969336
Entity Type
Individual
Name
Russell Donald De Lap, ATC
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC
Enumeration Date
Feb 15, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
12800 N LAKE SHORE DR
City
Mequon
ZIP Code
53097-2418
Phone
(262) 243-4323

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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