Healthcare Provider Details

I. General information

NPI: 1023355625
Provider Name (Legal Business Name): CHRISTOPHER C LYNCH MT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 HOSPITAL LOOP ROAD
OWYHEE NV
89832
US

IV. Provider business mailing address

1623 HOSPITAL LOOP ROAD
OWYHEE NV
89832
US

V. Phone/Fax

Practice location:
  • Phone: 775-757-2415
  • Fax: 775-757-3333
Mailing address:
  • Phone: 775-757-2415
  • Fax: 775-757-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number15455TGS-3
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: