Russon, Daniel Stark
Russon, Daniel Stark is an sole proprietor health care provider with primary practice located at 1800 Flandro Dr Ste 190 , Pocatello ID 83202-4940. 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. Russon, Daniel Stark can be contacted via phone (208) 233-2248.Contact Information
Primary practice address
1800 Flandro Dr Ste 190
Pocatello ID 83202-4940
Phone: (208) 233-2248
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 9150 | Idaho |
Profile Details
| NPI number | 1962242669 |
|---|---|
| LBN Legal business name | Russon, Daniel Stark |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 29th, 2024 |
| Last updated | May 29th, 2024 - about last year |
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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