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Individual

RUSSELL G. FORSBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9305 W THOMAS RD, SUITE 380, PHOENIX, AZ 85037-3328
(623) 327-4144
Mailing address
9305 W THOMAS RD, SUITE 380, PHOENIX, AZ 85037-3328

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3769
AZ

Other

Enumeration date
12/07/2007
Last updated
03/17/2008
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