Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Sep 20, 2006
License(s)
35049825 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4881 STATE ROUTE 125 | Georgetown, OH 45121-9550 | 937-378-2526 |
| LOCATION | 4881 STATE ROUTE 125 | Georgetown, OH 45121-9550 | 937-378-2526 |
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