Organization
RUSSELL R GIST OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL R GIST O.D. (PRESIDENT)
(515) 965-8488
Entity
Organization
Contact information
Practice address
1810 SW WHITE BIRCH CIR, SUITE 109, ANKENY, IA 50023-7226
(515) 965-8488
(515) 965-8499
Mailing address
1810 SW WHITE BIRCH CIR, SUITE 109, ANKENY, IA 50023-7226
(515) 965-8488
(515) 965-8499
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
05/23/2006
Last updated
11/15/2007
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