MEDICARE: CARLEE L LYNCH PT

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	225100000X	Physical Therapist	17597-24	WI

General Provider Information

NPI Number	:	1306797139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLEE L LYNCH PT

Provider Business Mailing Address
First Line	:	225000 HUMMINGBIRD RD STE 100
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54401-2950
Country	:	US
Telephone Number	:	715-359-6442
Fax Number	:	715-393-0390

Provider Business Practice Location Address
First Line	:	1767 PARK AVE
Second Line	:
City	:	PLOVER
State	:	WI
Zip	:	54467-4301
Country	:	US
Telephone Number	:	715-359-6442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/11/2026

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