Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Dec 11, 2006
License(s)
35.137367 (OH), 25MA08624400 (NJ), 259770 (NY), MD61239203 (WA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1735 27TH ST STE 308 | Portsmouth, OH 45662 | 740-356-7546 |
| MAILING | 1735 27TH ST STE B06 | Portsmouth, OH 45662-2681 | 740-356-8681 |
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