Jay T Rust JR., PA

NPI #1710185186 in New London, Wisconsin

Provider Information

NPI Number: 1710185186
Entity Type: Individual
Name: Jay T Rust JR., PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jul 6, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1405 MILL ST
City: New London
State: Wisconsin
ZIP Code: 54961-2155
Phone: (920) 531-2400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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