Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Jun 13, 2013
License(s)
5101020623 (MI), 34.012200 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2142 N COVE BLVD | Toledo, OH 43606-3895 | 419-291-1111 |
| MAILING | 100 MADISON AVE | Toledo, OH 43604-1516 |
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