Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Nov 20, 2006
License(s)
MD00043077 (WA), 061685 (GA), DR.0067148 (CO)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 743 SPRING ST NE | Gainesville, GA 30501-3715 | 770-533-6645 |
| MAILING | PO BOX 658 | Gainesville, GA 30503-0658 | 770-718-1122 |
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