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1548097827
LAVENICE J GRACE
LEESBURG, GA
NPI
1548097827
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
Enumeration Date
2024-09-19
Last Update Date
2024-09-19
Business Address
LAVENICE J GRACE
245 OAKLAND PKWY APT 1201
LEESBURG, GA 31763-1835
Phone number: 229-376-6065
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Mailing Address
LAVENICE J GRACE
245 OAKLAND PKWY APT 1201
LEESBURG, GA 31763-1835
Phone number: 229-376-6065
Copy
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