Peter Damon Russotto, DPM

NPI #1770576829 in Jacksonville, Illinois

Provider Information

NPI Number: 1770576829
Entity Type: Individual
Name: Peter Damon Russotto, DPM
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Podiatrist
Credential: DPM
Enumeration Date: Aug 24, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 1440 W WALNUT ST
Address 2: #5
City: Jacksonville
State: Illinois
ZIP Code: 62650-1143
Phone: (217) 243-3668

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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