Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 19, 2012
License(s)
0010-03846 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 338 HOWARD BLVD PO BOX 969 | Newport, NC 28570-7928 | 252-223-5054 |
| LOCATION | 338 HOWARD BLVD | Newport, NC 28570-7928 | 252-223-5054 |
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