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General NPI Number Information
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NPI Number | 1689886780
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Entity Type | Individual
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Provider Name | HERBERT E LYKEN MSPT
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 525 WASHINGTON ST
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City | STOUGHTON
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State | MA
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Zip | 02072-4219
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Country | US
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Telephone | 781-344-4449
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Fax | 781-344-1170
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Provider Business Mailing Address
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Address Line | 20 EMELINE ST
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City | RANDOLPH
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State | MA
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Zip | 02368-1917
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Country | US
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Telephone | 781-223-5287
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10533
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License Number State | MA
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