Individual
RUSSELL PURDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1076 LAYTON HILLS MALL STE 2090, LAYTON, UT 84041-2104
(801) 546-0255
(801) 546-0260
Mailing address
1901 PARKWAY BLVD, SALT LAKE CITY, UT 84119-2001
(801) 886-2020
(801) 954-0054
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
113333-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241764
DMBA
UT
05
—
999000797009
—
UT
Enumeration date
10/10/2006
Last updated
07/16/2008
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