Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 31, 2005
License(s)
14458 (WV)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 840 | Lima, OH 45802-0840 | 877-574-7116 |
| LOCATION | 4605 MACCORKLE AVE SW | South Charleston, WV 25309-1311 | 304-766-3600 |
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