Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 19, 2016
License(s)
23291 (NY), 50.004035 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 525 CHESTNUT COMMONS DR | Elyria, OH 44035-9611 | 440-406-8153 |
| MAILING | 211 EDGEFIELD BLVD | Marion, OH 43302-5801 | 740-914-4178 |
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