Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 11, 2007
License(s)
068093 (GA), 0101281466 (VA), 2004015135 (MO), 068093 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1000 JOHNSON FERRY RD | Atlanta, GA 30342 | 404-851-6323 |
| MAILING | 5605 GLENRIDGE DR STE 325 | Atlanta, GA 30342-1365 | 678-553-7783 |
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