Individual
JACOB LAGOMARCINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
935 SHOTWELL RD, SUITE 108, CLAYTON, NC 27520-5597
(919) 550-0821
Mailing address
450 S EAST ST, RALEIGH, NC 27601-2054
(630) 649-0035
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05433
NC
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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