Graduated: 2022
NPI: 1366181398
Practice Locations (3)
1208 KING ST, SUITE 405
CHATTANOOGA, TN 374034352
PO BOX, SUITE 25537
SALT LAKE CITY, UT 84125
PO BOX, SUITE 27128
SALT LAKE CITY, UT 84127
Source: CMS National Downloadable File, September 2026.