Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DAMATO (CONTRACTS MANAGER)
(805) 264-3388
Entity
Organization
Contact information
Practice address
1130 COFFEE RD BLDG 5, MODESTO, CA 95355-4228
(805) 736-7886
Mailing address
218 NORTH I STREET, LOMPOC, CA 93436
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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