Medical school: JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Graduated: 2004
Offers telehealth
NPI: 1942414040
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES MT
500 W BROADWAY ST, SPH INPATIENT PHY SERVICES
MISSOULA, MT 598024096
4065437271
Source: CMS National Downloadable File, September 2026.