Graduated: 2014
NPI: 1255793444
Practice Locations (2)
LAKE WALES PHYSICIAN SERVICES, LLC
410 S 11TH ST
LAKE WALES, FL 338534203
8636761433
PIKEVILLE MEDICAL CENTER INC
911 BYPASS RD, BLDG A
PIKEVILLE, KY 415011689
6064303500
Source: CMS National Downloadable File, September 2026.