David R Russell Od

NPI #1700076643 in Evanston, Wyoming

Provider Information

NPI Number: 1700076643
Entity Type: Organization
Organization Name: David R Russell Od
Primary Specialty: Optometrist
Enumeration Date: Jul 26, 2007
Last Updated: Aug 2, 2018

Practice Location

Address: 720 6TH ST
City: Evanston
State: Wyoming
ZIP Code: 82930
Phone: (307) 789-1500

Authorized Official

Name: DAVID R RUSSELL, OD
Title: PRESIDENT
Phone: (307) 789-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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