Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jun 30, 2011
License(s)
266903-1 (NY), ME158621 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 12902 USF MAGNOLIA DR | Tampa, FL 33612-9416 | 888-663-3488 |
| MAILING | PO BOX 198441 | Atlanta, GA 30384-8441 |
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