Organization
FIRST LIGHT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY BURNETTE (OFFICE MANAGER)
(540) 400-7841
Entity
Organization
Contact information
Practice address
706 CAMPBELL AVE SW, ROANOKE, VA 24016-3534
(540) 400-7841
(540) 400-8177
Mailing address
706 CAMPBELL AVE SW, ROANOKE, VA 24016-3534
(540) 400-7841
(540) 400-8177
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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