Medical school: PHILADELPHIA COL OF OSTEO MED, SEWANEE
Graduated: 2024
NPI: 1780444695
Practice Locations (2)
110 E MEDICAL LN, SUITE 210A
WEST COLUMBIA, SC 291694817
PO BOX, SUITE 6069
WEST COLUMBIA, SC 29171
Source: CMS National Downloadable File, September 2026.