Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Aug 1, 2006
License(s)
57567 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 148 BILL CARRUTH PKWY. SUITE 280 | Hiram, GA 30141 | 678-363-3343 |
| LOCATION | 148 BILL CARRUTH PKWY. SUITE 280 | Hiram, GA 30141 | 678-363-3343 |
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