Graduated: 1999
NPI: 1891711883
Practice Locations (2)
GREEN CLINIC LLC
1809 NORTHPOINTE LN, 102 QUICKCARE OF RUSTON
RUSTON, LA 712703852
3182553762
CLHG-RUSTON LLC
411 E VAUGHN AVE, SUITE 104
RUSTON, LA 712705975
31825424535975
Source: CMS National Downloadable File, September 2026.