Graduated: 2016
NPI: 1740934249
Practice Locations (2)
EAST TENNESSEE STATE UNIVERSITY
202 W FAIRVIEW AVE
JOHNSON CITY, TN 376045611
4234397371
EAST TENNESSEE STATE UNIVERSITY
2151 CENTURY LN
JOHNSON CITY, TN 376044469
4239262500
Source: CMS National Downloadable File, September 2026.