Trent Russell, PA

NPI #1457630642 in Murray, Utah

Provider Information

NPI Number: 1457630642
Entity Type: Individual
Name: Trent Russell, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Aug 5, 2011
Last Updated: Aug 5, 2011

Practice Location

Address: 5444 GREEN ST
City: Murray
State: Utah
ZIP Code: 84123-5632
Phone: (801) 262-8120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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