Organization
OPTIMUM HEALTH OF L'VILLE-GRAYSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P LANIER MD (OWNER)
(678) 985-7286
Entity
Organization
Contact information
Practice address
2445 MOON RD, GRAYSON, GA 30017-7851
(678) 985-7286
(678) 985-7287
Mailing address
2855 HIGHWAY 317 STE 760-318, SUWANEE, GA 30024-3563
(678) 546-0550
(678) 546-6885
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIRO006867
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
028809
GA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
028809
GA
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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