Graduated: 2023
NPI: 1235816810
Practice Locations (2)
FAMILY PRACTICE CLINIC OF BOONEVILLE, INC.
200 MULBERRY ST, SUITE A
BOONEVILLE, KY 413147505
6065936023
MOUNTAIN FAMILY PRACTICE CLINIC OF MANCHESTER INC
108 MANCHESTER SHOPPING CTR
MANCHESTER, KY 409621401
6066586333
Source: CMS National Downloadable File, September 2026.