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Organization

PHOENIX CLINIC AND AFTERHOUR CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARIE LIGHTBOURNE MD (OWNER)
(678) 386-2929
Entity
Organization

Contact information

Practice address
2795 MAIN ST W # 21, SNELLVILLE, GA 30078-3164
(678) 386-2929
Mailing address
5858 SILVER RIDGE DR, STONE MOUNTAIN, GA 30087-2322
(678) 386-2929

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
060359
GA

Other

Enumeration date
08/22/2018
Last updated
08/22/2018
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