Individual
MARI-LYN ELLENA LYNCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
603 PHOENIX ST, DELAVAN, WI 53115-2227
(262) 749-2103
Mailing address
603 PHOENIX ST, DELAVAN, WI 53115-2227
(262) 749-2103
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
321688-31
WI
Other
Enumeration date
09/06/2017
Last updated
07/21/2022
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