Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 19, 2016
License(s)
0010-06178 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 120 WILLIAM PENN PLZ | Durham, NC 27704-2150 | 919-220-5255 |
| LOCATION | 1803 FOREST HILLS RD W | Wilson, NC 27893-3412 | 252-243-9629 |
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