Individual
LYNN TIMOTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
1279 W JORDAN RIVER DR, SOUTH JORDAN, UT 84095-8250
(801) 253-5193
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
194753-3102
UT
Other
Enumeration date
06/24/2012
Last updated
06/24/2012
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