Russon, Bergen D
Russon, Bergen D is an individual health care provider with primary practice located at 11175 S Redwood Rd , South Jordan UT 84095-8208. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist, which is considered as her primary health care specialty. Russon, Bergen D can be contacted via phone (801) 359-4600.Contact Information
Primary practice address
11175 S Redwood Rd
South Jordan UT 84095-8208
Phone: (801) 359-4600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist | 225800000X | 11046853-4002 | Utah |
Profile Details
| NPI number | 1861952913 |
|---|---|
| LBN Legal business name | Russon, Bergen D |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2019 |
| Last updated | Mar 24th, 2019 - about 5 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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