Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Jun 25, 2007
License(s)
21934 (GA), 282871 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2002 ALICE ST | Waycross, GA 31501-6210 | 912-283-8444 |
| MAILING | PO BOX 173 | Waycross, GA 31502-0173 | 912-283-8444 |
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