Graduated: 2022
NPI: 1326753492
Practice Locations (2)
PROVIDENCE MEDICAL GROUP
2320 BEECHWOOD DR
GERMANTOWN, OH 453279462
9378954092
ALLIANCE PHYSICIANS INC
6147 STATE ROUTE 122
MIDDLETOWN, OH 450055201
5132613500513261
Source: CMS National Downloadable File, September 2026.