Graduated: 1990
NPI: 1477683993
Practice Locations (2)
REVOLUTION SPORT AND SPINE THERAPY LLC
35249 KENAI SPUR HWY, SUITE C
SOLDOTNA, AK 996697623
REVOLUTION SPORT AND SPINE THERAPY LLC
35249 KENAI SPUR HWY, SUITE C
SOLDOTNA, AK 996697673
9074200836
Source: CMS National Downloadable File, September 2026.