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Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY D'AMATO (CONTRACTS MANAGER)
(805) 264-3388
Entity
Organization
Contact information
Practice address
1015 25TH ST SE, SALEM, OR 97301-5049
(503) 477-8645
Mailing address
218 N I ST, LOMPOC, CA 93436-0909
(805) 736-7886
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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