Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Sep 30, 2005
License(s)
29458 (NC), 29458 (NC), 29458 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 614 N BROAD ST | Seagrove, NC 27341-8613 | 336-873-7248 |
| LOCATION | 614 N BROAD ST | Seagrove, NC 27341-8613 | 336-873-7248 |
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