Individual
ELSHA CACHET RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
448 E 5350 S, SUITE B, WASHINGTON TERRACE, UT 84405-5414
(801) 721-4422
Mailing address
448 E 5350 S, SUITE B, WASHINGTON TERRACE, UT 84405-5414
(801) 721-4422
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
159618398
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159618398
LICENSE STATE OF UT
UT
Enumeration date
07/14/2015
Last updated
07/14/2015
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