Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 3, 2012
License(s)
0101268879 (VA), 2014-00811 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3022 CROASDAILE DR | Durham, NC 27705-6802 | 303-708-3050 |
| MAILING | 3022 CROASDAILE DR | Durham, NC 27705-6802 | 303-708-3050 |
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