Graduated: 1997
NPI: 1407952195
Practice Locations (2)
MAINSTREET AND KIDSSTREET OF NORTH CAROLINA PLLC
130 JAMES AVE
LOCUST, NC 280974506
7042964508
COUNTY OF CLEVELAND NORTH CAROLINA
200 S POST RD
SHELBY, NC 281526269
9804845100
Source: CMS National Downloadable File, September 2026.