Graduated: 2015
NPI: 1336514645
Practice Locations (2)
COUNTY OF YAVAPAI
51 S BRIAN MICKELSEN PKWY
COTTONWOOD, AZ 863263610
9286398132
COUNTY OF YAVAPAI
1090 COMMERCE DR
PRESCOTT, AZ 863053700
9285831000
Source: CMS National Downloadable File, September 2026.