Graduated: 2001
NPI: 1306968540
Practice Locations (3)
CLINICS OF THE SOUTHEAST LLC
219 S BORDER DR
BOGALUSA, LA 704273671
9856331952
CLINICS OF THE SOUTHEAST LLC
405 AVE F
BOGALUSA, LA 704273633
9857321568
ULTRA HEALTH LLC
200 MEDICAL CIR
TYLERTOWN, MS 396672069
7313941145
Source: CMS National Downloadable File, September 2026.