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Organization

LA CLINIQUE LLC

Active
Other names
Nova Star Medical Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
RAMSES VEGA-CASASNOVAS MD (OWNER)
(336) 688-6240
Entity
Organization

Contact information

Practice address
1240 N THORNTON AVE, DALTON, GA 30720-3605
(706) 229-9313
(706) 229-9388
Mailing address
1240 N THORNTON AVE, DALTON, GA 30720-3605
(706) 229-9313
(706) 229-9388

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician

Other

Enumeration date
12/04/2023
Last updated
08/25/2025
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