Graduated: 2025
NPI: 1447132063
Practice Locations (4)
PO BOX
LEWISTON, ME 04243
36 LANCASTER ST
Lynbrook, NY 115631844
200 W MARTIN LUTHER KING BLVD, SUITE 1000
CHATTANOOGA, TN 374022571
200 W MARTIN LUTHER KING BLVD, SUITE 1000
CHATTANOOGA, TN 37403
Source: CMS National Downloadable File, September 2026.