Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jul 18, 2006
License(s)
0101288474 (VA), 200600416 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3186 VILLAGE DR STE 201 | Fayetteville, NC 28304-3979 | 910-486-5700 |
| LOCATION | 3186 VILLAGE DR 201 | Fayetteville, NC 28304-3979 | 910-486-5700 |
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