Medical school: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated: 1973
NPI: 1609817246
Practice Locations (1)
OSUP COMMUNITY OUTREACH LLC
6100 N HAMILTON RD
WESTERVILLE, OH 430812062
6142934969
Source: CMS National Downloadable File, September 2026.