Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
May 20, 2006
License(s)
ME136892 (FL), 65631 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 742616 | Atlanta, GA 30374-2616 | 770-219-8420 |
| LOCATION | 108 PROMINENCE CT STE 200 | Dawsonville, GA 30534-6340 | 706-216-3238 |
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