Davis, Russell
Davis, Russell is an sole proprietor health care provider with primary practice located at 1887 Aaron Dr Ste B , Tooele UT 84074-8138. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Davis, Russell can be contacted via phone (435) 775-9969.Contact Information
Primary practice address
1887 Aaron Dr Ste B
Tooele UT 84074-8138
Phone: (435) 775-9969
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4988445-4405 | Utah |
Profile Details
| NPI number | 1982148581 |
|---|---|
| LBN Legal business name | Davis, Russell |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 15th, 2016 |
| Last updated | Jul 20th, 2018 - about 7 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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