MEDICARE: LYNN'S PERFECT FIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	CFM01423	TN

General Provider Information

NPI Number	:	1285839811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNN'S PERFECT FIT

Provider Business Mailing Address
First Line	:	2838 HICKORY HILL RD
Second Line	:	28
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2173
Country	:	US
Telephone Number	:	901-546-7572
Fax Number	:	901-546-7572

Provider Business Practice Location Address
First Line	:	2838 HICKORY HILL RD
Second Line	:	SUITE 28
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2173
Country	:	US
Telephone Number	:	901-546-7572
Fax Number	:	901-546-7572

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LINDA FAYE REDDICK
Credential	:	CFM
Telephone Number	:	901-546-7572

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	07/17/2009

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Directions to “LYNN'S PERFECT FIT ” Practice Location

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