LAVENICE J GRACE

LEESBURG, GA
NPI1548097827
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171W00000X Contractor
Enumeration Date2024-09-19
Last Update Date2024-09-19
Business Address
LAVENICE J GRACE
245 OAKLAND PKWY APT 1201
LEESBURG, GA 31763-1835
Phone number: 229-376-6065
Mailing Address
LAVENICE J GRACE
245 OAKLAND PKWY APT 1201
LEESBURG, GA 31763-1835
Phone number: 229-376-6065