Graduated: 1993
NPI: 1376536714
Practice Locations (5)
PROACTIVE THERAPY OF NORTH CAROLINA INC
1109 MEMORIAL DR E
AHOSKIE, NC 279103919
2523326760
VIDANT MEDICAL GROUP LLC
401 A N MAIN ST
KENANSVILLE, NC 283498801
9102960941
VIDANT MEDICAL GROUP LLC
401 N MAIN ST
KENANSVILLE, NC 283498801
9102960941
VIDANT MEDICAL GROUP LLC
417 N MAIN ST
KENANSVILLE, NC 283498801
9102968080
VIDANT MEDICAL GROUP LLC
171 NC HWY 125, SUITE A
ROANOKE RAPIDS, NC 278706460
2525375631
Source: CMS National Downloadable File, September 2026.