Graduated: 1983
NPI: 1114512746
Practice Locations (2)
GEORGIA PINES COMMUNITY SERVICE BOARD
615 N MAIN ST
MOULTRIE, GA 317683319
2292254335
GEORGIA PINES COMMUNITY SERVICE BOARD
1102 SMITH AVE
THOMASVILLE, GA 317925740
9122275468
Source: CMS National Downloadable File, September 2026.