Graduated: 2019
NPI: 1871149856
Practice Locations (3)
BROAD RIVER REHABILITATION
9120 WILLOW RIDGE RD
CHARLOTTE, NC 282108313
82877452220027
LIFESOURCE OF NORTH CAROLINA
3205 RANDALL PKWY, SUITE 105
WILMINGTON, NC 284032565
9107429243
LIFESOURCE PRIME INC
3205 RANDALL PKWY, SUITE 105
WILMINGTON, NC 284032565
9107429243
Source: CMS National Downloadable File, September 2026.