Graduated: 2018
NPI: 1568950426
Practice Locations (2)
LIFESOURCE OF NORTH CAROLINA
939 SPRINGDALE DR
CLINTON, SC 293257266
9107429243
LIFESOURCE PRIME INC
939 SPRINGDALE DR
CLINTON, SC 293257266
9107429243
Source: CMS National Downloadable File, September 2026.