Individual
KIMBERLI C. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
777 N MAIN ST, EPHRAIM, UT 84627-1165
(435) 283-8194
Mailing address
805 S 300 E, EPHRAIM, UT 84627-1610
(435) 283-5758
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
131561-1701
UT
Other
Enumeration date
12/07/2006
Last updated
07/08/2007
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