Individual
KAYLA NICOLE LYNUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 CHERRY AVE W, PLUM CITY, WI 54761-9781
(715) 647-2401
Mailing address
149 250TH ST, WOODVILLE, WI 54028-7218
(715) 977-2333
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
521191
WI
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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