Individual
RUSSELL B PINCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
910 S 300 W, BLANDING, UT 84511-3921
(435) 651-3700
(435) 678-0608
Mailing address
PO BOX 130, MONTEZUMA CREEK, UT 84534-0130
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
49201274405
UT
Other
Enumeration date
06/16/2011
Last updated
03/07/2022
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