Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Jul 5, 2007
License(s)
2272 (TN), 076627 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 551420 | Fort Lauderdale, FL 33355-1420 | 800-243-3839 |
| LOCATION | 440 WAGES RD | Auburn, GA 30011-2855 | 770-277-3056 |
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