Graduated: 1992
NPI: 1861771131
Practice Locations (2)
SHANNON CLINIC
3350 EXECUTIVE DR
SAN ANGELO, TX 769046878
3257471511
MONONGALIA COUNTY GENERAL HOSPITAL COMPANY
1200 J D ANDERSON DR
MORGANTOWN, WV 265053494
3045981200
Source: CMS National Downloadable File, September 2026.