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General NPI Number Information
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NPI Number | 1316448343
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Entity Type | Individual
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Provider Name | KARL LYNHAM LMT
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Gender | Male
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Dates
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Enumeration Date | 02/25/2018
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1200 E WOODHURST DR R300
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City | SPRINGFIELD
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State | MO
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Zip | 65804
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Country | US
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Telephone | 417-877-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 W WALNUT LAWN ST APT K3
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City | SPRINGFIELD
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State | MO
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Zip | 65807-4676
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Country | US
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Telephone | 417-848-7241
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2105011391
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License Number State | MO
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