Graduated: 1987
Offers telehealth
NPI: 1669801551
Practice Locations (2)
LIFESOURCE OF NORTH CAROLINA
5530 NORTHOP RD
MILTON, FL 325708701
9107429243
LIFESOURCE OF NORTH CAROLINA
1345 REDMOND CIR NW
ROME, GA 301651307
9107429243
Source: CMS National Downloadable File, September 2026.