Individual
ALEXANDRIA RUZICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4411 ALBY STREET, ALTON, IL 62002
(618) 474-8052
Mailing address
4411 ALBY STREET, ALTON, IL 62002
(618) 474-8052
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004855
IL
Other
Enumeration date
12/29/2013
Last updated
06/18/2014
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