RUSSELL WILLIAM LUNDBERG

LOGAN, UT
NPI1881997120
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
(Licence: UT  171M00000X)
Enumeration Date2010-12-08
Last Update Date2010-12-08
Business Address
-- RUSSELL WILLIAM LUNDBERG
90 E 200 N
LOGAN, UT 84321-4034
Phone number: 435-752-0791
Mailing Address
-- RUSSELL WILLIAM LUNDBERG
166 W 100 N
SMITHFIELD, UT 84335-2002
Phone number: