Russell Ellis Lark PH.D.

NPI 1083872642 - Psychologist - 103TC1900X

NPI Details
NPI 1083872642
Gender Male
Enumeration Date 05/29/2008
Last Updated 05/29/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1200 VALLEY WEST DR
SUITE 707
WEST DES MOINES IA, 50266-1908, US
Phone (515) 222-1999
Fax (515) 224-3949
Business Location
1200 VALLEY WEST DR
SUITE 707
WEST DES MOINES IA, 50266-1908, US
Phone
Fax
Toxanomy
Taxonomy Code 103TC1900X
License State Iowa
License Number 001057
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According to our database, Dr. Russell Ellis Lark PH.D. NPI is 1083872642, taxonomy code is 103TC1900X and license number is 001057, license state is located at Iowa. Russell Ellis Lark PH.D. physically located at 1200 Valley West Dr, West Des Moines IA, 50266-1908. NPI Number Russell Ellis Lark PH.D. has the Individual type.

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1083872642 NPI number is provided on an as is basis without warranty of any kind. 1083872642 is maintained by the National Plan & Provider Enumeration System. The contents of Russell Ellis Lark PH.D. are for informational purposes only.