Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 26, 2006
License(s)
5601002351 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 550 MUNSON AVE | Traverse City, MI 49686-3580 | 231-935-8712 |
| LOCATION | 550 MUNSON AVE | Traverse City, MI 49686-3580 | 231-935-8712 |
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