Graduated: 2020
NPI: 1073974168
Practice Locations (2)
LEGACY PRIMARY CARE PLLC
3124 COLORADO LN
BISMARCK, ND 585035447
7015164637
LEGACY MEDICAL LLC
3124 COLORADO LN, APT 709
BISMARCK, ND 585035451
7015164637
Source: CMS National Downloadable File, September 2026.