Individual
MISS MARY E LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
1696 W MAIN CR, #28, DEPERE, WI 54115
(920) 360-4199
Mailing address
1696 W MAIN CIR, #28, DEPERE, WI 54115
(920) 360-4199
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
818-039
WI
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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