Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 12, 2022
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 212 GREEN TREE TAVERN RD | North Wales, PA 19454-1250 | 267-670-0540 |
| LOCATION | 212 GREEN TREE TAVERN RD | North Wales, PA 19454-1250 | 267-670-0540 |
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