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General NPI Number Information
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NPI Number | 1487896726
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Entity Type | Individual
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Provider Name | MATTHEW ALLEN LYNCH LMT
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Gender | Male
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 7410 DIXIE HWY
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City | LOUISVILLE
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State | KY
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Zip | 40258-1406
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Country | US
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Telephone | 502-995-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 3705.5 HAMBURG PK APT 2
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130
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Country | US
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Telephone | 812-284-2727
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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 | KY-2396
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License Number State | KY
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