Individual
DR. LYNETTE MAE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DHS, ATC
Contact information
Practice address
635 EXECUTIVE DR, WILLOWBROOK, IL 60527-5603
(630) 455-6630
(630) 455-6631
Mailing address
1131 STRINGERS RIDGE RD APT 2K, CHATTANOOGA, TN 37405-3238
(630) 674-2584
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096.002040
IL
2255A2300X
Athletic Trainer
Primary
528
TN
Other
Enumeration date
02/21/2006
Last updated
08/29/2017
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