Registry details
Type
Individual
Primary specialty
Dermatology, MOHS-Micrographic Surgery
Enumerated
Aug 25, 2006
License(s)
5601093226 (MI), 5601093226 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3434 RIVERTOWN POINT CT SW | Grandville, MI 49418-3076 | 616-257-3344 |
| MAILING | 3434 RIVERTOWN POINT CT SW | Grandville, MI 49418-3076 | 616-257-3344 |
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