Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Mar 23, 2007
License(s)
C0003463 (MD), MA056328 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 135 WALTER DR | Lewisburg, PA 17837-7482 | 570-524-7777 |
| LOCATION | 135 WALTER DR | Lewisburg, PA 17837-7482 | 570-524-7777 |
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