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General NPI Number Information
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NPI Number | 1922616143
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Entity Type | Organization
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Legal Business Name | LYNCH VEIN AND AESTHETICS PLLC
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 26900 N LAKE PLEASANT PKWY
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City | PEORIA
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State | AZ
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Zip | 85383-1558
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Country | US
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Telephone | 623-524-8960
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Fax |
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Provider Business Mailing Address
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Address Line | 26900 N LAKE PLEASANT PKWY
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City | PEORIA
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State | AZ
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Zip | 85383-1558
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER/MEDICAL DIRECTOR
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Name | MATTHEW LYNCH
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Credential | MD
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Telephone | 608-745-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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