Graduated: 2021
NPI: 1467111989
Practice Locations (2)
EASTLAKE MEDICAL, LLC
2205 JACKSBORO PIKE
LA FOLLETTE, TN 377662904
4233526500
EASTLAKE MEDICAL, LLC
2205 JACKSBORO PIKE, SUITE 6
LA FOLLETTE, TN 377662904
Source: CMS National Downloadable File, September 2026.