Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 17, 2011
License(s)
2017-00485 (NC), 27504 (NV), 2017-00485 (NC), 2017-00485 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 101 MANNING DR BLDG 2 | Chapel Hill, NC 27514-4423 | 919-966-1884 |
| MAILING | PO BOX 3247 | Indianapolis, IN 46206-3247 | 918-392-1705 |
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