Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jun 2, 2006
License(s)
35.076246 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 222 PIEDMONT AVE SUITE 5300 | Cincinnati, OH 45219-4231 | 513-475-7630 |
| MAILING | PO BOX 636256 CENTRAL CREDENTIALING | Cincinnati, OH 45263-6256 | 513-585-5502 |
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