Lavenice J Grace

NPI #1548097827 in Leesburg, Georgia

Provider Information

NPI Number: 1548097827
Entity Type: Individual
Name: Lavenice J Grace
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Enumeration Date: Sep 19, 2024
Last Updated: Sep 19, 2024

Practice Location

Address: 245 OAKLAND PKWY APT 1201
City: Leesburg
State: Georgia
ZIP Code: 31763-1835
Phone: (229) 376-6065

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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