Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Apr 14, 2006
License(s)
000103200 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 60968 | Charlotte, NC 28260-0968 | 843-237-3378 |
| LOCATION | 3000 NEW BERN AVE | Raleigh, NC 27610-1231 | 843-237-3378 |
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