Graduated: 2023
NPI: 1386497865
Practice Locations (2)
KEJAC VENTURES LLC
1282 UNION AVE
MEMPHIS, TN 381043414
9017616157
SOUTHEASTERN PHYSICIAN SERVICES PC
6019 WALNUT GROVE RD
MEMPHIS, TN 381202113
9012265000
Source: CMS National Downloadable File, September 2026.