Graduated: 2021
NPI: 1225887847
Practice Locations (2)
THEORIA MEDICAL
901 N CHARLOTTE ST
DICKSON, TN 370551010
6154465171
SOUTHEASTERN PHYSICIAN SERVICES PC
6019 WALNUT GROVE RD
MEMPHIS, TN 381202113
9012265000
Source: CMS National Downloadable File, September 2026.