Graduated: 2020
NPI: 1588295620
Practice Locations (3)
479 SHOREFIELD DR
Chippewa Lake, OH 442159721
479 SHOREFIELD DR
CHIPPEWA LAKE, OH 442159721
140 WADSWORTH RD
WADSWORTH, OH 442819503
2166266801
Source: CMS National Downloadable File, September 2026.