Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Jun 22, 2006
License(s)
2009-00701 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 634 | Warsaw, NC 28398-0634 | 910-293-7246 |
| LOCATION | 113 S PINE ST | Warsaw, NC 28398-1924 | 910-293-7246 |
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