Russell Keith

NPI #1780983072 in Blanding, Utah

Provider Information

NPI Number: 1780983072
Entity Type: Individual
Name: Russell Keith
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Mar 25, 2011
Last Updated: Mar 25, 2011

Practice Location

Address: 356 S MAIN ST
City: Blanding
State: Utah
ZIP Code: 84511-3830
Phone: (435) 678-2992

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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