Medical school: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated: 1993
NPI: 1154317790
Practice Locations (3)
3214 ROOSEVELT HWY
Manchester, GA 318166418
3214 ROOSEVELT HWY
MANCHESTER, GA 318166418
7068463151
P O BOX, SUITE 3188
MANCHESTER, GA 318163188
Source: CMS National Downloadable File, September 2026.