Graduated: 1997
NPI: 1215923958
Practice Locations (3)
3421 W 9TH ST
WATERLOO, IA 507025401
2045 W GRAND AVE, SUITE B28354
CHICAGO, IL 606121576
200 W MARTIN LUTHER KING BLVD, SUITE 1000
CHATTANOOGA, TN 374022571
Source: CMS National Downloadable File, September 2026.