Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
May 16, 2016
License(s)
PA2163 (KY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 776351 | Chicago, IL 60677-6351 | 502-588-9490 |
| LOCATION | 1 AUDUBON PLAZA DR | Louisville, KY 40217 | 502-634-6767 |
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