Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Mar 6, 2012
License(s)
BM4400379242 (OH), R7366 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 140 HILLCREST MEDICAL BLVD STE 2 | Waco, TX 76712-8897 | 254-741-1400 |
| MAILING | PO BOX 848476 | Dallas, TX 75284-8476 | 254-202-4655 |
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