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1235163858
RUSSEL GROVER LADWIG
MADERA, CA
NPI
1235163858
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA17196)
Enumeration Date
2006-07-10
Last Update Date
2022-03-23
Business Address
Mr. RUSSEL GROVER LADWIG PAC
9300 VALLEY CHILDRENS PL
MADERA, CA 93636-8762
Phone number: 559-353-3000
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Mailing Address
Mr. RUSSEL GROVER LADWIG PAC
644 E PINTAIL CIRCLE
FRESNO, CA 93720-1266
Phone number: 599-433-9282
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