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General NPI Number Information
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NPI Number | 1346218591
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Entity Type | Individual
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Provider Name | LYNN R GABE OD
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 05/05/2009
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Provider Practice Location Address
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Address Line | 280 N WHITE MOUNTAIN RD STE 18A
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City | SHOW LOW
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State | AZ
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Zip | 85901-5273
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Country | US
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Telephone | 928-537-5565
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Fax | 928-537-7597
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Provider Business Mailing Address
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Address Line | 280 N WHITE MOUNTAIN RD STE 18A
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City | SHOW LOW
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State | AZ
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Zip | 85901-5273
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Country | US
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Telephone | 928-537-5565
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Fax | 928-537-7597
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 68
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License Number State | AZ
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