Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Sep 22, 2006
License(s)
35069313A (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 7225 OLD OAK BLVD STE A210 | Middleburg Heights, OH 44130-3339 | 440-816-8303 |
| MAILING | 7225 OLD OAK BLVD SUITE 210A | Middleburg Heights, OH 44130-3339 | 440-816-2761 |
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.