Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Oct 28, 2009
License(s)
MA054190 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 801 YORK ST | Manitowoc, WI 54220-4630 | 920-663-9008 |
| LOCATION | 5500 CORPORATE DR STE 320 | Pittsburgh, PA 15237-5848 | 412-435-1170 |
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