Medical school: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1998
NPI: 1124197793
Practice Locations (3)
DECOACH TEAM LLC
302 W MAIN ST
FAIRBORN, OH 453245037
9372814673
DECOACH TEAM LLC
6570 SOSNA DR
Fairfield, OH 450142222
DECOACH TEAM LLC
6570 SOSNA DR
FAIRFIELD, OH 450142222
5139424673
Source: CMS National Downloadable File, September 2026.