Organization
JOHN C. LINCOLN, LLC
Active
Parent organization
JOHN C. LINCOLN, LLC
Other names
John C. Lincoln LifeStream at Thunderbird
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN C. LINCOLN, LLC
Authorized official
NATHAN ANSPACH (SR. VICE PRESIDENT)
(623) 434-6200
Entity
Organization
Contact information
Practice address
13617 N 55TH AVE, GLENDALE, AZ 85304-4701
(602) 544-8541
Mailing address
PO BOX 9907, PHOENIX, AZ 85068-0907
(623) 434-6155
(623) 434-6149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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