Graduated: 2009
NPI: 1467687376
Practice Locations (2)
PROACTIVE THERAPY OF NORTH CAROLINA INC
1109 MEMORIAL DR E
AHOSKIE, NC 279103919
2523326760
VIDANT MEDICAL GROUP LLC
2325 STANTONSBURG RD
GREENVILLE, NC 278347534
9197314048
Source: CMS National Downloadable File, September 2026.