Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Jun 7, 2007
License(s)
2010-00389 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 105 YADKIN ST SUITE 301 | Albemarle, NC 28001-3449 | 704-982-9144 |
| MAILING | PO BOX 601888 | Charlotte, NC 28260-1888 | 704-982-9144 |
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