Graduated: 2021
NPI: 1023773132
Practice Locations (2)
COUNTY LINE PRIMARY CARE
1550 HWY 15 S, SUITE 240
JACKSON, KY 413390709
6068245037
PPL THERAPEUTIC SERVICES PLLC
147 N HIGHLAND AVE
PRESTONSBURG, KY 416537748
6068862378
Source: CMS National Downloadable File, September 2026.