Graduated: 2023
NPI: 1417648916
Practice Locations (3)
LIFESOURCE OF NORTH CAROLINA
1345 REDMOND CIR NW
ROME, GA 301651307
9107429243
LIFESOURCE OF NORTH CAROLINA
939 SPRINGDALE DR
CLINTON, SC 293257266
9107429243
LIFESOURCE PRIME INC
939 SPRINGDALE DR
CLINTON, SC 293257266
9107429243
Source: CMS National Downloadable File, September 2026.