Individual
PHYLLICIA MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.T.
Contact information
Practice address
214 PONCE DE LEON AVE NE, SUITE 1, ATLANTA, GA 30308-1910
(404) 987-6596
Mailing address
214 PONCE DE LEON AVE NE, SUITE 1, ATLANTA, GA 30308-1910
(678) 600-1523
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
MT004039
GA
Other
Enumeration date
09/26/2015
Last updated
09/26/2015
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