Graduated: 1996
NPI: 1700995206
Practice Locations (2)
COFFEE COUNTY HOSPITAL GROUP INC
482 INTERSTATE DR, SUITE A
MANCHESTER, TN 373553109
9317284718
ULTACARE MEDICAL PLLC
606 N BROAD ST
NEW TAZEWELL, TN 378256610
4232595002
Source: CMS National Downloadable File, September 2026.