MEDICARE: DR. CONNOR DANIEL LYNCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1396604815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CONNOR DANIEL LYNCH

Provider Business Mailing Address
First Line	:	1101 HAWTHORNE LN APT 265
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-2982
Country	:	US
Telephone Number	:	989-698-6240
Fax Number	:

Provider Business Practice Location Address
First Line	:	5935 CARNEGIE BLVD STE 265
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-4645
Country	:	US
Telephone Number	:	980-467-2542
Fax Number	:	980-467-2543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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