Graduated: 2016
NPI: 1457708380
Practice Locations (2)
KENTUCKY MSO LLC
1502 OXFORD DR, SUITE 100
GEORGETOWN, KY 403248096
5025703785
WELLMONT MEDICAL ASSOCIATES INC
378 MARKETPLACE DR, SUITE 5
JOHNSON CITY, TN 376042361
4232820751
Source: CMS National Downloadable File, September 2026.