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General NPI Number Information
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NPI Number | 1841238268
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Entity Type | Organization
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Legal Business Name | CYNTHIA L LYDIARD
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 62 SUFFIELD ST
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City | AGAWAM
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State | MA
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Zip | 01001-1752
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Country | US
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Telephone | 413-786-3383
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Fax | 413-786-2388
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Provider Business Mailing Address
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Address Line | 62 SUFFIELD ST
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City | AGAWAM
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State | MA
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Zip | 01001-1752
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Country | US
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Telephone | 413-786-3383
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MS. CYNTHIA LEE LYDIARD
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Credential | CERTIFIED FITTER
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Telephone | 413-786-3383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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