Organization
DAVID R RUSSELL OD
Active
Other names
Vision Source, Accurate Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID R RUSSELL OD (PRESIDENT)
(307) 789-1500
Entity
Organization
Contact information
Practice address
720 6TH ST, EVANSTON, WY 82930
(307) 789-1500
(307) 789-0077
Mailing address
916 MAIN ST, EVANSTON, WY 82930-3441
(307) 789-1500
(307) 789-0077
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
293T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121954500
—
WY
Enumeration date
07/26/2007
Last updated
08/02/2018
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