MEDICARE: LYNN NAVARRE P.T.

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	18134	MD

General Provider Information

NPI Number	:	1891715660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN NAVARRE P.T.

Provider Business Mailing Address
First Line	:	9839 SNOW BIRD LN
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20723-5609
Country	:	US
Telephone Number	:	301-362-1710
Fax Number	:

Provider Business Practice Location Address
First Line	:	11085 LITTLE PATUXENT PKWY STE 101
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2914
Country	:	US
Telephone Number	:	410-760-8840
Fax Number	:	410-760-8847

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/21/2022

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