Individual
EMILY RUSSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
951 S GENEVA RD, OREM, UT 84058-5857
(720) 841-3417
Mailing address
951 S GENEVA RD, OREM, UT 84058-5857
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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