Registry details
Type
Organization
Primary specialty
Nurse Practitioner
Enumerated
Oct 21, 2019
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2100 VIRGINIA ST STE F | Grand Prairie, TX 75051-3796 | 214-862-5756 |
| MAILING | 1204 STAR GRASS DR | Mansfield, TX 76063-1688 | 312-307-1295 |
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