Medical school: NORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1985
NPI: 1770571069
Practice Locations (2)
153 /2 N BROADWAY
SUGARCREEK, OH 44681
3308523211
153 /2 N BROADWAY, P O BOX 218
SUGARCREEK, OH 44681
Source: CMS National Downloadable File, September 2026.