Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jun 11, 2010
License(s)
MD464693 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 333 COTTMAN AVE | Philadelphia, PA 19111-2434 | 215-728-3883 |
| MAILING | 2450 W HUNTING PARK AVE | Philadelphia, PA 19129-1302 | 215-728-3883 |
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