Clarke, Russell Lionel

Clarke, Russell Lionel is an individual health care provider with primary practice located at 1577 W 7000 S 100, West Jordan UT 84084-7492. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Clarke, Russell Lionel can be contacted via phone (801) 566-6301.

Contact Information

Primary practice address
1577 W 7000 S 100 West Jordan UT 84084-7492
Phone: (801) 566-6301
Fax: (801) 566-4739
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 279763-2401 Utah

Profile Details

NPI number 1396894267
LBN Legal business name Clarke, Russell Lionel
Credentials P.T., C.H.T.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396894267 NPPES
Utah Other 279763-2401 LICENSE NUMBER

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