Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
May 21, 2007
License(s)
4301083368 (MI), 35126011 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 636643 | Cincinnati, OH 45263-6643 | 440-960-4900 |
| LOCATION | 3500 KOLBE RD PALLIATIVE CARE DEPT | Lorain, OH 44053-1632 | 440-960-4900 |
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