Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 26, 2024
License(s)
0010-14936 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 216 MOORE RD | King, NC 27021-8703 | 336-983-4346 |
| MAILING | PO BOX 751803 | Charlotte, NC 28275-1803 | 336-983-4346 |
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