Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Sep 29, 2023
License(s)
PA17188 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 7777 FOREST LN STE B332 | Dallas, TX 75230-6822 | 972-566-7788 |
| MAILING | PO BOX 603725 | Charlotte, NC 28260-3725 | 828-575-2625 |
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