Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Sep 4, 2008
License(s)
036.123697 (IL), 0101245826 (VA), 35093991 (OH), 35093991 (OH), 51034 (MN), 036.123697 (IL), 0101245826 (VA), 103882 (MN)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1134 N MAIN ST STE 3100 | Bellefontaine, OH 43311-0017 | 937-651-6441 |
| LOCATION | 1134 N MAIN ST STE 3100 | Bellefontaine, OH 43311-0017 | 937-651-6441 |
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