Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
May 15, 2018
License(s)
FA1462489 (PA), MD476472 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3421 CONCORD RD | York, PA 17402-9001 | 717-263-8463 |
| LOCATION | 12 ST PAUL DR STE 104 | Chambersburg, PA 17201-1035 | 717-263-8463 |
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