Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jun 6, 2011
License(s)
ME123433 (FL), 49691 (KY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 7300 TURFWAY RD | Florence, KY 41042-1375 | 859-371-3376 |
| MAILING | PO BOX 635283 | Cincinnati, OH 45263-5283 | 859-371-3376 |
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