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General NPI Number Information
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NPI Number | 1114041035
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Entity Type | Organization
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Legal Business Name | LYNDON FAMILY HEALTH CARE CLINIC
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Dates
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Enumeration Date | 03/17/2007
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 1128 SW FAIRLAWN RD
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City | TOPEKA
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State | KS
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Zip | 66604-2020
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Country | US
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Telephone | 785-478-9625
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Fax | 785-271-4392
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Provider Business Mailing Address
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Address Line | PO BOX 4795
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City | TOPEKA
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State | KS
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Zip | 66604-0795
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Country | US
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Telephone | 785-478-9625
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Fax | 785-271-4392
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Authorized Official
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Title or Position | OWNER
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Name | CHERYL LYNN WEST
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Credential | ARNP
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Telephone | 785-478-9625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 44473
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License Number State | KS
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