Graduated: 2012
NPI: 1104248418
Practice Locations (4)
PO BOX, SUITE 2257
CHESTERTON, IN 46304
1160 W BROAD ST
Columbus, OH 432221352
1160 W BROAD ST
COLUMBUS, OH 432221352
1083 FIRTH AVE
Worthington, OH 430852913
Source: CMS National Downloadable File, September 2026.