Graduated: 2020
NPI: 1033748512
Practice Locations (2)
SHASTA ORTHOPEDICS AND SPORTS MEDICINE A MEDICAL CORPORATION
1255 LIBERTY ST
REDDING, CA 960010814
5302462467
ORTHOPAEDIC CENTER OF IL
1301 S KOKE MILL RD
SPRINGFIELD, IL 627119252
2175479100
Source: CMS National Downloadable File, September 2026.