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Connie Russell
NPI 1518509637 · on the registry since 2019 · sole proprietor
Practice
- Address
- 1205 E Bonner Way
Salt Lake City, UT 84117 - Phone
- (801) 598-8337
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Also registered as
- 163W00000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-10-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah