Individual
CATHERINE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4252 S HIGHLAND DR STE 200, SALT LAKE CITY, UT 84124-2690
(801) 993-1800
Mailing address
285 E FORT UNION BLVD UNIT 32, MIDVALE, UT 84047-1570
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
13502894-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
13502894-1206
UT
Other
Enumeration date
09/07/2023
Last updated
01/23/2025
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