Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Jul 15, 2019
License(s)
25MP00525500 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 339 E STREET RD | Trevose, PA 19053-7711 | 215-464-4111 |
| MAILING | 339 E STREET RD | Trevose, PA 19053-7711 | 215-464-4111 |
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