Individual
STACY L LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
(262) 334-3451
(262) 306-2964
Mailing address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
(262) 334-3451
(262) 306-2964
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
51189
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346214673
—
WI
05
—
188617700
—
MN
Enumeration date
02/14/2006
Last updated
12/03/2014
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