Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1999
NPI: 1386612653
Practice Locations (5)
COMMUNITY MEMORIAL HOSPITAL ASSOCIATION
512 SKYLINE BLVD
CLOQUET, MN 557203787
2188794641
LEGACY PRIMARY CARE PLLC
4195 WESTBERG RD
HERMANTOWN, MN 558112962
7015164637
LEGACY MEDICAL LLC
4195 WESTBERG RD, APT 436
HERMANTOWN, MN 558113888
7015164637
LEGACY MEDICAL LLC
2100 S COLUMBIA RD, SUITE 114
GRAND FORKS, ND 582015895
7015164637
LEGACY PRIMARY CARE PLLC
2100 S COLUMBIA RD, SUITE 114
GRAND FORKS, ND 582015895
7015164637
Source: CMS National Downloadable File, September 2026.