Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jan 24, 2013
License(s)
12422 (GA), 12422 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 100 POST OAK TRL | Athens, GA 30606-1300 | 705-353-0454 |
| MAILING | 100 POST OAK TRL | Athens, GA 30606-1300 | 705-353-0454 |
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