Graduated: 2006
NPI: 1417123688
Practice Locations (2)
NORTHERN LIGHTS HEALTH LLC
212 W LAKE ST
WACONIA, MN 553871014
6516034565
NORTHERN LIGHTS HEALTH LLC
750 E LOUISIANA ST
SAINT CROIX FALLS, WI 540249501
7154839815
Source: CMS National Downloadable File, September 2026.