Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Aug 3, 2010
License(s)
4301094480 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4201 SAINT ANTOINE ST | Detroit, MI 48201-2153 | |
| LOCATION | 100 E CAMPUS VIEW BLVD STE 100 | Columbus, OH 43235-8628 | 313-745-3430 |
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