Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DAMATO (CONTRACTS DIRECTOR)
(805) 264-3388
Entity
Organization
Contact information
Practice address
11820 NE CRESTWOOD DR STE 100, VANCOUVER, WA 98684-5103
(805) 264-3388
Mailing address
218 N I ST, LOMPOC, CA 93436-0909
(805) 264-3388
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
01/25/2019
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