Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jun 8, 2012
License(s)
MT200829 (PA), MD463655 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 95 HIGHLAND AVE STE 130 | Bethlehem, PA 18017 | 610-868-1100 |
| MAILING | 95 HIGHLAND AVE STE 130 | Bethlehem, PA 18017-9483 | 610-868-1100 |
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