Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Mar 23, 2021
License(s)
2022-02125 (NC), 0101280947 (VA), 0101280947 (VA), 2022-02125 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 213 S JEFFERSON ST STE 1006 | Roanoke, VA 24011-1713 | 540-224-5372 |
| LOCATION | 180 FLOYD AVE | Rocky Mount, VA 24151-1318 | 540-483-5277 |
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