Individual
JOSHUA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
106 RIDGEWATER DR STE A, POLSON, MT 59860-8977
(406) 883-3200
(406) 883-9483
Mailing address
106 RIDGEWATER DR STE A, POLSON, MT 59860-8977
(406) 883-3200
(406) 883-9483
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
70011
MT
Other
Enumeration date
11/08/2018
Last updated
11/27/2023
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