Graduated: 2006
NPI: 1669672382
Practice Locations (2)
AMERICAN SPECIALTY PHYSICIANS GROUP INC
173 E WEBSTER ST
COLUSA, CA 959322949
2092876308
ICCO LLC
1740 NW GOETZ ST
ROSEBURG, OR 974711613
5416724885
Source: CMS National Downloadable File, September 2026.