Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Jun 26, 2006
License(s)
0010-00289 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1340 BOYLSTON ST | Boston, MA 02215-4302 | 252-456-2181 |
| LOCATION | 986 MANSON/AXTELL RD. | Manson, NC 27553 | 252-456-2181 |
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