Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Aug 5, 2006
License(s)
28453 (NC), 0101051899 (VA), 28453 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 221249 | Charlotte, NC 28222-1249 | 704-332-1291 |
| LOCATION | 3623 LATROBE DRIVE STE 216 | Charlotte, NC 28211 | 704-332-1291 |
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