Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Oct 4, 2005
License(s)
034757 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3020 HIGHWAY 124 | Snellville, GA 30039-4614 | 770-978-1331 |
| LOCATION | 3020 HIGHWAY 124 | Snellville, GA 30039-4614 | 770-978-1331 |
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