Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Sep 21, 2006
License(s)
50001228 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 74571 | Cleveland, OH 44194 | 216-383-6480 |
| LOCATION | 18599 LAKESHORE #200 | Euclid, OH 44119 | 216-383-0100 |
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