Individual
MS. LYNN CORRIE IRVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1508 N LINDEN ST, BLOOMINGTON, IL 61701-1942
(309) 261-1509
(309) 527-3999
Mailing address
1508 N LINDEN ST, BLOOMINGTON, IL 61701-1942
(309) 261-1509
(309) 527-3999
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
LI59770209P
IL
Other
Enumeration date
03/04/2009
Last updated
03/04/2009
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