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Organization

LIGHTHOUSE CHIROPRACTIC CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAIME GONZALEZ D.C. (OWNER)
(770) 503-0500
Entity
Organization

Contact information

Practice address
3458 WINDER HWY, SUITE 120, FLOWERY BRANCH, GA 30542-3007
(770) 503-0500
(770) 503-0635
Mailing address
3458 WINDER HWY, SUITE 120, FLOWERY BRANCH, GA 30542-3007
(770) 503-0500
(770) 503-0635

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006987
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1669443859
NPI TYPE 1 NUMBER
GA
Enumeration date
12/11/2006
Last updated
08/22/2020
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