Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Dec 11, 2025
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2150 W CENTRAL AVE | Toledo, OH 43606-3834 | |
| LOCATION | 2150 W CENTRAL AVE | Toledo, OH 43606-3834 | 419-291-8701 |
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