Clark, Russell
Clark, Russell is an individual health care provider with primary practice located at 3101 E State St Ste 2108 , Eagle ID 83616-6232. He recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as his primary health care specialty. Clark, Russell can be contacted via phone (208) 385-3480.Contact Information
Primary practice address
3101 E State St Ste 2108
Eagle ID 83616-6232
Phone: (208) 385-3480
Fax: (208) 385-3481
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | AUD-1526 | Idaho |
Profile Details
| NPI number | 1538692249 |
|---|---|
| LBN Legal business name | Clark, Russell |
| Credentials | AUD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2017 |
| Last updated | Mar 1st, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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