Graduated: 1995
NPI: 1760403141
Practice Locations (2)
LEGACY HEALTHCARE SERVICES INC
9642 BURKE LAKE RD
BURKE, VA 220153052
7035437920
PRIME CARE FAMILY PRACTICE PC
4700 PUDDLEDOCK RD, SUITE 300
PRINCE GEORGE, VA 238751268
8045261111122
Source: CMS National Downloadable File, September 2026.