Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Jun 3, 2013
License(s)
2016-01820 (NC), 2016-01820 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 201 E GROVER ST | Shelby, NC 28150-3917 | 980-487-3678 |
| MAILING | PO BOX 19305 | Charlotte, NC 28219-9305 |
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