Organization
PRESTIGE MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY DICKERSON AGNP-C (OWNER)
(706) 333-9932
Entity
Organization
Contact information
Practice address
4529 STERLING POINTE DR NW, KENNESAW, GA 30152-7321
(706) 333-9932
Mailing address
PO BOX 1712, KENNESAW, GA 30156-8712
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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