Organization
LGN WEIGHT LOSS, LLC
Active
Other names
LGN Weight Loss
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DONNA THAYER (MANAGER)
(276) 644-2009
Entity
Organization
Contact information
Practice address
1114 E MAIN ST STE 6, LEBANON, VA 24266-5014
(276) 525-1800
Mailing address
PO BOX 306, LEBANON, VA 24266-0306
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0101252617
VA
Other
Enumeration date
04/20/2018
Last updated
04/27/2018
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