Organization
MAGNOLIA LANE PLASTIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAYLOR CATO (OFFICE MANAGER)
(706) 723-1632
Entity
Organization
Contact information
Practice address
3633 WHEELER RD STE 110, AUGUSTA, GA 30909-6544
(706) 723-1632
(706) 869-3841
Mailing address
607 RONALD REAGAN DR UNIT 724, EVANS, GA 30809-7729
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
03/06/2024
Last updated
08/26/2024
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