Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DANIEL STARK RUSSON, DPT, PT
Active Sole ProprietorPhysical Therapy Assistant · KIMBERLY, ID
Registration Details
- NPI Number
- 1962242669
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 29, 2024 (1.9175600342479 yrs)
- Last Updated
- Jun 24, 2025
- License
-
PT-9150 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
931 CENTER ST W STE CKIMBERLY, ID, 833415326Browse ID providers · Browse ZIP 83341
- Phone
- 2084239999
- Fax
- 2084239998
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in KIMBERLY, ID
| Name | Credential | NPI |
|---|---|---|
| REAGAN RONALD WARD | DPT | 1114374741 |
| AMMON BENJAMIN BIRK | DPT | 1851889182 |
| DR. TREVOR JOHN BAKER | PT, DPT, GCS | 1912496753 |
| MICHELLE M SMITH | DPT, PT | 1083305296 |
| ASHLYN MARIE ZOON | DPT | 1497529333 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.