Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jan 16, 2007
License(s)
MD021109E (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 239 MAIN ST SUITE 400 | Johnstown, PA 15901-1640 | 814-539-5987 |
| LOCATION | 1086 FRANKLIN ST | Johnstown, PA 15905-4305 | 814-539-5987 |
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