# LGN WEIGHT LOSS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LGN Weight Loss
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861989105
- **Authorized official:** MISS DONNA THAYER (MANAGER)
- **Authorized official phone:** (276) 644-2009

## Contact information

- **Practice address:** 1114 E MAIN ST STE 6, LEBANON, VA 24266-5014
- **Practice address phone:** (276) 525-1800
- **Mailing address:** PO BOX 306, LEBANON, VA 24266-0306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 0101252617 | VA | Yes |

## Other

- **Enumeration date:** 04/20/2018
- **Last updated:** 04/27/2018