Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jul 21, 2006
License(s)
200401471 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1927 3RD AVENUE LN SE | Hickory, NC 28602-2960 | 828-328-3500 |
| MAILING | 315 19TH ST SE | Hickory, NC 28602-4230 | 828-325-9849 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.