Graduated: 2020
NPI: 1013545946
Practice Locations (3)
MIRACL LLC
1000 W 10TH ST, PHELPS HEALTH
ROLLA, MO 654012905
5733649000
RADIOLOGY AND IMAGING SPECIALISTS OF LAKELAND
4643 LINDELL BLVD, APT 919
SAINT LOUIS, MO 631083735
8002292273
WASHINGTON UNIVERSITY
510 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 631101016
31436272001
Source: CMS National Downloadable File, September 2026.