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Individual

TAYLA RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
185 W 600 N, MANTUA, UT 84324-4398
(435) 553-5698
Mailing address
6556 S BIG COTTONWOOD CYN, SUITE #300, HOLLADAY, UT 84121-3580

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
05/11/2017
Last updated
05/11/2017
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