Graduated: 2024
NPI: 1326851437
Practice Locations (2)
BOLD CITY THERAPY AND WELLNESS LLC
1605 KING ST
JACKSONVILLE, FL 322044563
9045510946
RED CANYON LLC
801 TOLL HOUSE AVE, SUITE H3
FREDERICK, MD 217016117
2405759260
Source: CMS National Downloadable File, September 2026.