Graduated: 2008
NPI: 1972758480
Practice Locations (2)
VIDANT MEDICAL GROUP LLC
2100 STANTONSBURG RD
GREENVILLE, NC 278342818
2528471757
PROACTIVE THERAPY OF NORTH CAROLINA INC
2303 WELLINGTON DR SW, SUITE B
WILSON, NC 278938620
2522436818
Source: CMS National Downloadable File, September 2026.