Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Dec 4, 2009
License(s)
35.122804 (OH), 35.122804 (OH), 23890 (WV)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1003 BELLEFONTAINE AVE STE 200 | Lima, OH 45804-2868 | 419-224-5915 |
| MAILING | 1001 BELLEFONTAINE AVE | Lima, OH 45804-2800 | 419-998-4575 |
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