Graduated: 1987
NPI: 1205998366
Practice Locations (4)
MT GRANT GENERAL HOSPITAL
200 S A ST
HAWTHORNE, NV 894151510
7759452461
NV PACS 2 LLC
3530 KEITH ST NW
CLEVELAND, TN 373124309
4234763254
IPC PAC HEALTHCARE SERVICES OF TENNESSEE PC
505 N ROAN ST
JOHNSON CITY, TN 376014740
4239752000
IPC PAC HEALTHCARE SERVICES OF TENNESSEE PC
100 NETHERLAND LN
KINGSPORT, TN 376607245
4232450360
Source: CMS National Downloadable File, September 2026.