Organization
LALA LAND ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUSTIN C CONNELL CRNA (MANAGER)
(229) 392-8840
Entity
Organization
Contact information
Practice address
276 BELFLOWER RD, TIFTON, GA 31794-1607
(229) 392-8840
(478) 333-6117
Mailing address
276 BELFLOWER RD, TIFTON, GA 31794-1607
(229) 392-8840
(478) 333-6117
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN167296
GA
Other
Enumeration date
05/16/2017
Last updated
07/21/2022
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