Individual
MRS. LYNNETTE MARIE WITHERELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1500 7TH ST, LINCOLN, IL 62656-2284
(217) 732-8616
Mailing address
1500 7TH ST, LINCOLN, IL 62656-2284
(217) 732-8616
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
057001593
IL
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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