Graduated: 2001
NPI: 1225659501
Practice Locations (3)
1208 KING ST, SUITE 405
CHATTANOOGA, TN 374034352
PO BOX, SUITE 27128
SALT LAKE CITY, UT 84127
PO BOX, SUITE 30180
SALT LAKE CITY, UT 84130
Source: CMS National Downloadable File, September 2026.