Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Mar 22, 2012
License(s)
MD455798 (PA), MD455798 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 100 N ACADEMY AVE | Danville, PA 17822-4903 | 570-271-6144 |
| LOCATION | 16 WOODBINE LANE | Danville, PA 17822-2515 | 570-271-8050 |
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