Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Apr 24, 2007
License(s)
004766 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1000 HAWTHORNE AVE STE J | Athens, GA 30606-2168 | 706-286-8344 |
| MAILING | PO BOX 48298 | Athens, GA 30604-8298 | 706-543-3449 |
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