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General NPI Number Information
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NPI Number | 1720480858
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Entity Type | Individual
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Provider Name | LYNNE AMY BOOTH M.D
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Gender | Female
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 555 N DUKE ST
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City | LANCASTER
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State | PA
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Zip | 17602
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Country | US
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Telephone | 717-544-4940
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Fax |
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Provider Business Mailing Address
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Address Line | 5360 LINCOLN HWY STE 15
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City | GAP
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State | PA
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Zip | 17527-9461
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Country | US
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Telephone | 717-442-8111
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Fax | 717-442-8981
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD474143
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License Number State | PA
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