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NPI Code Detail

MEDICARE: MRS. PATRICIA JO LYNCH LPTA

MEDICARE: MRS. PATRICIA JO LYNCH LPTA
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
1225200000XPhysical Therapy Assistant1623-019WI

General Provider Information

NPI Number : 1538437173
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA JO LYNCH LPTA
Provider Business Mailing Address
First Line : 2448 S 102ND ST
Second Line : SUITE 340
City : MILWAUKEE
State : WI
Zip : 53227-2466
Country : US
Telephone Number : 414-329-2500
Fax Number : 414-329-2501
Provider Business Practice Location Address
First Line : W76N677 WAUWATOSA RD
Second Line :
City : CEDARBURG
State : WI
Zip : 53012-1707
Country : US
Telephone Number : 262-377-5060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2011
Last Update Date : 12/10/2011

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