Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Sep 6, 2005
License(s)
58569 (GA), 58569 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3525 PIEDMONT RD NE BUILDING 6, SUITE 220 | Atlanta, GA 30305-1578 | 404-446-3200 |
| LOCATION | 2400 BELLEVUE RD STE 21A | Dublin, GA 31021-2890 | 478-328-0281 |
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