Individual
LYNNETTE GLASSCHO TOMLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2475 BROAD ST, SUMTER, SC 29150-1820
(803) 778-6555
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1726
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1304
—
SC
01
—
7124
MEDICARE NUMBER
SC
Enumeration date
12/01/2011
Last updated
11/12/2024
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