Registry details
Type
Individual
Primary specialty
Internal Medicine, Cardiovascular Disease
Enumerated
Jan 27, 2006
License(s)
71047 (TN), 35-07-8350-A (OH), 35078350 (OH), 24143 (NE), 35.078350 (OH), 01054842A (IN), V2605 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 500 W MAIN ST STE 380 | Lewisville, TX 75057-3606 | 214-258-1070 |
| LOCATION | 278 BARKS RD W | Marion, OH 43302-7367 | 740-383-7980 |
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