Graduated: 2002
NPI: 1922575570
Practice Locations (3)
KEWEENAW BAY INDIAN COMMUNITY
102 S SUPERIOR AVE
BARAGA, MI 499089673
9063536623
LAC VIEUX DESERT BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
N5241 US HWY
Watersmeet, MI 499690009
LAC VIEUX DESERT BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
N5241 US HWY
WATERSMEET, MI 499690009
9063584588
Source: CMS National Downloadable File, September 2026.