DANIEL STARK RUSSON

POCATELLO, ID
NPI1962242669
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  9150)
Enumeration Date2024-05-29
Last Update Date2024-05-29
Business Address
DANIEL STARK RUSSON DPT
1800 FLANDRO DR STE 190
POCATELLO, ID 83202-4940
Phone number: 208-233-2248
Mailing Address
DANIEL STARK RUSSON DPT
1730 W QUINN RD TRLR 222
POCATELLO, ID 83202-2883
Phone number: 801-836-5334
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