Healthcare Provider Details

I. General information

NPI: 1003969080
Provider Name (Legal Business Name): LYNN M. ALLISON D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 REGENT ST SUITE 1030
SARATOGA SPRINGS NY
12866-4307
US

IV. Provider business mailing address

153 REGENT ST SUITE 1030
SARATOGA SPRINGS NY
12866-4307
US

V. Phone/Fax

Practice location:
  • Phone: 518-268-9542
  • Fax:
Mailing address:
  • Phone: 518-268-9542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX006745-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: