Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Nov 30, 2005
License(s)
9401111 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 6905 KNIGHTDALE BLVD STE 106 | Knightdale, NC 27545-6505 | 919-261-8760 |
| MAILING | 1600 PERIMETER PARK DR SUITE 225 | Morrisville, NC 27560-8421 |
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