Graduated: 2020
NPI: 1922674522
Practice Locations (2)
ST MARYS REGIONAL HEALTH CENTER
1027 WASHINGTON AVE
DETROIT LAKES, MN 565013409
2188475611
REJUV MEDICAL PA
901 3RD ST N
WAITE PARK, MN 563871964
3202178480
Source: CMS National Downloadable File, September 2026.