Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 19, 2006
License(s)
PA12252 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | BOX 432 | Midpines, CA 95345-0432 | 209-966-8395 |
| LOCATION | 5185 HOSPITAL RD JOHN C FREMONT RURAL HEALTH | Mariposa, CA 95338 | 209-966-3631 |
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