Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Jul 14, 2011
License(s)
1510 (SC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 603898 | Charlotte, NC 28260-3898 | 843-792-6200 |
| LOCATION | 805 PAMPLICO HWY | Florence, SC 29505-6047 | 843-674-2500 |
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