Graduated: 2019
NPI: 1831729870
Practice Locations (2)
POUDRE VALLEY MEDICAL GROUP LLC
8540 SCARBOROUGH DR
COLORADO SPRINGS, CO 809207502
7199554200
CAPITAL CITY MEDICAL GROUP, L.L.C.
7049 PERKINS RD
BATON ROUGE, LA 708084320
2259267200
Source: CMS National Downloadable File, September 2026.