Graduated: 2014
NPI: 1063835494
Practice Locations (2)
RED CANYON LLC
801 TOLL HOUSE AVE, SUITE H3
FREDERICK, MD 217016117
2405759260
RED CANYON LLC
3501 JOHN SIMMONS ST, SUITE A203
URBANA, MD 217047964
3018828382
Source: CMS National Downloadable File, September 2026.