Bergen D Russon
Bergen D Russon is a Recreation Therapist in South Jordan, Utah. Licensed in Utah. Registered with an NPI since 2019.
- Licensed in
- UT
- In the registry since
- 2019
Practice location Address checks out
11175 S Redwood RdSouth Jordan, UT 84095-8208
Phone: (801) 359-4600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Recreation Therapist (primary) | Taxonomy 225800000X · Licence 11046853-4002 (UT) |
|---|
Record details
| NPI number | 1861952913 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | March 24, 2019 |
| Last updated in NPPES | March 24, 2019 |
| Mailing address | 11175 S Redwood Rd, South Jordan, UT 84095-8208 |
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