Organization
RUSSELL T SNOW, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL T SNOW D.O. (PRESIDENT)
(208) 454-2050
Entity
Organization
Contact information
Practice address
119 W LOGAN ST STE A, CALDWELL, ID 83605-4732
(208) 454-2050
(208) 454-3554
Mailing address
119 W LOGAN ST STE A, CALDWELL, ID 83605-4732
(208) 454-2050
(208) 454-3554
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
O-110
ID
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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