Provider Demographics
NPI:1578865473
Name:LIGHT, LINDA B (DVM)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:B
Last Name:LIGHT
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE B-7
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1145 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITE B-7
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4054
Practice Address - Country:US
Practice Address - Phone:770-614-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-27
Last Update Date:2010-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5760174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian