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General NPI Number Information
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NPI Number | 1245990472
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Entity Type | Organization
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Legal Business Name | THERESA LYNCH CERTIFIED LYMPHEDEMA THERAPIST LLC
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 1044 CASTELLO DR STE 213
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City | NAPLES
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State | FL
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Zip | 34103-1900
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Country | US
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Telephone | 239-776-4001
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Fax | 949-757-6651
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Provider Business Mailing Address
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Address Line | 1044 CASTELLO DR STE 213
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City | NAPLES
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State | FL
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Zip | 34103-1900
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Country | US
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Telephone | 239-776-4001
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Fax | 949-757-6651
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | THERESA LYNCH
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Credential | OT
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Telephone | 239-776-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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