Graduated: 2000
NPI: 1699720284
Practice Locations (2)
LIFESOURCE OF NORTH CAROLINA
2500 RIVER HAVEN DR
HOOVER, AL 352441226
9107429243
LIFESOURCE OF NORTH CAROLINA
6450 OLD TUSCALOOSA HWY
MC CALLA, AL 351113606
9107429243
Source: CMS National Downloadable File, September 2026.