Graduated: 1994
NPI: 1790788701
Practice Locations (3)
3160 LEWIS AVE
IDA, MI 481409703
8884323621
6400 MONROE ST, SUITE C
SYLVANIA, OH 435601400
8444364987
PROMEDICA CENTRAL PHYSICIANS
2142 N COVE BLVD
TOLEDO, OH 436063895
4192914000
Source: CMS National Downloadable File, September 2026.