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Russell Clark, AUD
NPI 1538692249 · on the registry since 2017
Practice
- Address
- 3101 E State St Ste 2108
Eagle, ID 83616 - Phone
- (208) 385-3480
- Fax
- (208) 385-3481
- Organisation at this address
- University Professional Services
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 21
Registry record
- Primary taxonomy
- Audiologist
231H00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-03-01
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 Idaho