Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Dec 2, 2016
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3475 N SARATOGA ST | Oak Harbor, WA 98278-2652 | 360-257-9794 |
| MAILING | 5422 PRINCE DR | Lake Dallas, TX 75065-2652 | 940-368-8651 |
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