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General NPI Number Information
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NPI Number | 1366701559
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Entity Type | Individual
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Provider Name | DR. LYNN HATRICK
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Gender | Female
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 10 MONOCACY BLVD
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City | FREDERICK
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State | MD
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Zip | 21704-7256
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Country | US
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Telephone | 301-682-3459
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Fax |
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Provider Business Mailing Address
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Address Line | 825 DUNBROOKE CT
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City | FREDERICK
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State | MD
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Zip | 21701-9315
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Country | US
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Telephone | 301-514-7652
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA 1883
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License Number State | MD
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