Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jul 18, 2017
License(s)
MA059150 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 110 S 17TH ST | Harrisburg, PA 17104-1123 | 717-232-9971 |
| LOCATION | 110 S 17TH ST | Harrisburg, PA 17104-1123 | 717-232-9971 |
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