Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jul 12, 2013
License(s)
OA003068 (PA), MA056286 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 225 N FRONT ST | Steelton, PA 17113-2240 | 717-939-4593 |
| MAILING | 7 DOCK HILL RD | Middleburg, PA 17842-8910 | 570-837-2123 |
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