Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jun 7, 2016
License(s)
P16806 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 9209 BAYBROOK LN | Charlotte, NC 28277-3576 | 980-385-5192 |
| MAILING | 16033 FIELDSTONE TRCE | Charlotte, NC 28278-7023 |
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