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1982148581
RUSSELL DAVIS
TOOELE, UT
NPI
1982148581
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: UT 4988445-4405)
Enumeration Date
2016-12-15
Last Update Date
2018-07-20
Business Address
RUSSELL DAVIS
1887 AARON DR STE B
TOOELE, UT 84074-8138
Phone number: 435-775-9969
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Mailing Address
RUSSELL DAVIS
1887 N AARON DR SUITE B
TOOELE, UT 84074
Phone number: 435-775-9969
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