Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Mar 8, 2016
License(s)
2021-01101 (NC), 335659 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 192 PARK CLUB LN | Williamsville, NY 14221-5270 | 716-204-1101 |
| MAILING | MEDICAL CENTER BLVD | Winston Salem, NC 27157-0001 | 336-716-2255 |
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