Daniel Stark Russon, DPT, PT

NPI #1962242669 in Kimberly, Idaho

Provider Information

NPI Number: 1962242669
Entity Type: Individual
Name: Daniel Stark Russon, DPT, PT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: DPT, PT
Enumeration Date: May 29, 2024
Last Updated: Jun 24, 2025

Practice Location

Address: 931 CENTER ST W STE C
City: Kimberly
State: Idaho
ZIP Code: 83341-5326
Phone: (208) 423-9999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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