LABUTALE WALAWWE RAJAGURU

SUPERIOR, WI
NPI1346006772
Other NameUDARA RAJAGURU
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WI  7735)
Additional Taxonomies363A00000X Physician Assistant
(Licence: MN  14754)
Enumeration Date2024-02-23
Last Update Date2024-02-23
Business Address
LABUTALE WALAWWE RAJAGURU PA-C
3500 TOWER AVE
SUPERIOR, WI 54880-4491
Phone number: 715-817-7100
Mailing Address
LABUTALE WALAWWE RAJAGURU PA-C
400 E 3RD ST
DULUTH, MN 55805-1951
Phone number: 218-786-8364