Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
May 6, 2008
License(s)
4301107040 (MI), MT195499 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 26211 CENTRAL PARK BLVD STE 201 | Southfield, MI 48076-4158 | 833-667-3627 |
| LOCATION | 30575 WOODWARD AVE | Royal Oak, MI 48073-0980 | 248-280-8550 |
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