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Individual

DR. LYNNE A CHINTALA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1061 HARMON AVE, FT STEWART, GA 31314-5601
(912) 435-6350
(912) 435-6650
Mailing address
PO BOX 4076, FT STEWART, GA 31315-4076
(912) 435-5350
(912) 435-6650

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601001590
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0601001590
OPTOMETRY LICENSE
VA
Enumeration date
08/18/2005
Last updated
07/08/2007
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