Graduated: 2023
NPI: 1659085496
Practice Locations (2)
KETTERING INDEPENDENT MEDICAL GROUP INC
5348 LAMME RD
MORAINE, OH 454393215
9375344651
DECOACH TEAM LLC
36 N DETROIT ST
XENIA, OH 453852909
9376104673
Source: CMS National Downloadable File, September 2026.