Lagniappe LLC
NPI #1396188967 in Fayetteville, Georgia
Provider Information
- NPI Number
- 1396188967
- Entity Type
- Organization
- Organization Name
- Lagniappe LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Apr 12, 2013
- Last Updated
- Apr 12, 2013
Practice Location
- Address
- 1975 HIGHWAY 54 W
- Address 2
- SUITE 100
- City
- Fayetteville
- State
- Georgia
- ZIP Code
- 30214-4794
- Phone
- (770) 632-3730
Authorized Official
- Name
- DR. ANTHONY T CLAVO SR., M.D.
- Title
- PRESIDENT
- Phone
- (770) 632-3730
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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