Healthcare Provider Details

I. General information

NPI: 1649509399
Provider Name (Legal Business Name): LYNNE L ESPINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2009
Last Update Date: 12/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319A SOUTHBRIDGE ST
AUBURN MA
01501-2598
US

IV. Provider business mailing address

319A SOUTHBRIDGE ST
AUBURN MA
01501-2598
US

V. Phone/Fax

Practice location:
  • Phone: 508-832-2628
  • Fax: 508-832-7824
Mailing address:
  • Phone: 508-832-2628
  • Fax: 508-832-7824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number15662
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: