Graduated: 2014
NPI: 1184010936
Practice Locations (2)
PRIVIA MEDICAL GROUP INDIANA LLC
25651 COUNTY RD, SUITE 20
ELKHART, IN 465172310
5745221201
INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC
8930 W SUNSET RD, SUITE 140
LAS VEGAS, NV 891485009
7029683240
Source: CMS National Downloadable File, September 2026.