Graduated: 2022
NPI: 1740919224
Practice Locations (2)
LEGACY MEDICAL LLC
3124 COLORADO LN, APT 709
BISMARCK, ND 585035451
7015164637
LEGACY PRIMARY CARE PLLC
2100 S COLUMBIA RD, SUITE 114
GRAND FORKS, ND 582015895
7015164637
Source: CMS National Downloadable File, September 2026.