Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 14, 2013
License(s)
50.004964RX (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 700 ACKERMAN RD STE 2120 | Columbus, OH 43202-1559 | 614-293-7499 |
| LOCATION | 410 W 10TH AVE | Columbus, OH 43210-1240 | 614-293-7499 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.