Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Dec 31, 2015
License(s)
94254 (SC), 0101285597 (VA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 330 BROOKLINE AVE | Boston, MA 02215-5400 | 617-632-9236 |
| MAILING | 5220 GREENS DAIRY RD | Raleigh, NC 27616-4612 | 704-443-1564 |
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