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Individual

LYNN ANN FARROW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
3073 S CHASE AVE, SUITE 240, MILWAUKEE, WI 53207-2638
(414) 231-4223
(414) 489-0540
Mailing address
3535 MOUNTAIN DR, BROOKFIELD, WI 53045-1443
(262) 783-9890

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1289-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1289-26
WISCONSIN OT LICENSE
WI
Enumeration date
02/14/2013
Last updated
02/14/2013
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