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1184633711
RUSSEL T MCKENNA
LOGAN, UT
NPI
1184633711
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: UT 2851791204)
Enumeration Date
2006-08-05
Last Update Date
2007-07-08
Business Address
-- RUSSEL T MCKENNA DO
1325 N 600 E STE 101
LOGAN, UT 84341
Phone number: 435-750-5599
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Mailing Address
-- RUSSEL T MCKENNA DO
1325 N 600 E STE 101
LOGAN, UT 84341
Phone number: 435-750-5599
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