Provider Demographics
NPI:1235002809
Name:PHOENIX ONCOLOGY AND LYMPHEDEMA THERAPY, LLC
Entity type:Organization
Organization Name:PHOENIX ONCOLOGY AND LYMPHEDEMA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-695-7621
Mailing Address - Street 1:110 CRESTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-3715
Mailing Address - Country:US
Mailing Address - Phone:770-695-7621
Mailing Address - Fax:
Practice Address - Street 1:3465C LAWRENCEVILLE SUWANEE RD STE C
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2402
Practice Address - Country:US
Practice Address - Phone:770-695-7621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty