Graduated: 2005
NPI: 1164643201
Practice Locations (2)
LAKE REGIONAL HEALTH SYSTEM
1075 NICHOLS RD
OSAGE BEACH, MO 650653093
5733023990
LAKE REGIONAL HEALTH SYSTEM
54 HOSPITAL DR
OSAGE BEACH, MO 650653050
Source: CMS National Downloadable File, September 2026.