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1841572120
MARK RUSSELL
LOGAN, UT
NPI
1841572120
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: UT 7284773-1701)
Enumeration Date
2011-09-13
Last Update Date
2011-09-13
Business Address
MARK RUSSELL PHARMD, RPH
999 N MAIN ST
LOGAN, UT 84321-3230
Phone number: 435-227-1100
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Mailing Address
MARK RUSSELL PHARMD, RPH
14 S 490 E
SMITHFIELD, UT 84335-1220
Phone number: 435-563-2777
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