Graduated: 2004
NPI: 1407821598
Practice Locations (2)
LAKESHORE SURGERY ANESTHESIA BILLING
4190 24TH AVE
FORT GRATIOT, MI 480593882
8102164300
PRIME HEALTHCARE SERVICES-PORT HURON LLC
2601 ELECTRIC AVE, LAKE HURON MEDICAL CENTER
PORT HURON, MI 480606587
8102161500
Source: CMS National Downloadable File, September 2026.