Individual
RUSSELL EWBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 W MAIN ST, BRAWLEY, CA 92227-2244
(760) 925-3031
Mailing address
1134 S 8TH ST, EL CENTRO, CA 92243-3968
(619) 961-6156
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
52121
CA
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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