Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jul 17, 2014
License(s)
PA.0003981 (CO), 0010-06406 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1301 FAYETTEVILLE ST | Durham, NC 27707-2325 | 919-956-4000 |
| MAILING | 1301 FAYETTEVILLE ST | Durham, NC 27707-2325 | 919-956-4000 |
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