Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Mar 30, 2020
License(s)
94235 (SC), 2025-01351 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1915 RANDOLPH RD, 2ND FLOOR | Charlotte, NC 28207 | 704-323-2426 |
| MAILING | 4601 PARK RD STE 300 | Charlotte, NC 28209 |
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