Graduated: 2012
NPI: 1689914632
Practice Locations (2)
CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC
130 N MAIN ST
RIDGELY, TN 380801317
7312645518
CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC
710 CARL PERKINS PKWY
TIPTONVILLE, TN 380791678
7312536692
Source: CMS National Downloadable File, September 2026.