Individual
LAURA LYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
79 ROYAL PALM PT, VERO BEACH, FL 32960-4253
(561) 248-5955
Mailing address
12605 85TH ST, FELLSMERE, FL 32948-6810
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 64588
FL
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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