Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Oct 6, 2005
License(s)
97448 (GA), ME64091 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1818 SW 15TH AVE | Ocala, FL 34474-3548 | 352-671-4300 |
| MAILING | PO BOX 6200 | Ocala, FL 34478-6200 | 352-671-4300 |
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