Graduated: 1996
NPI: 1982647525
Practice Locations (2)
SELF REGIONAL HEALTHCARE
22580 HWY 76 E, SUITE 100
LAURENS, SC 293608460
8648335986
SELF MEDICAL GROUP
298 COMMERCE DR
NEWBERRY, SC 291082953
8033213232
Source: CMS National Downloadable File, September 2026.