Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 3, 2008
License(s)
5601005035 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 1024 | Cadillac, MI 49601-6024 | 231-775-6076 |
| LOCATION | 302 HOBART ST | Cadillac, MI 49601-2379 | 231-775-8814 |
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