Graduated: 2019
NPI: 1952950859
Practice Locations (3)
LEGACY HEALTHCARE SERVICES INC
548 WHITE OAKS DR
SALISBURY, NC 281478183
7046360271
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.