Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Aug 17, 2007
License(s)
2009-00890 (NC), 32465 (SC), 2009-00890 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3623 LATROBE DR SUITE 216 | Charlotte, NC 28211-4864 | 704-332-1291 |
| MAILING | PO BOX 221249 | Charlotte, NC 28222-1249 | 704-332-1291 |
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