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Individual

MR. LYNN C. BOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, ATC, LAT

Contact information

Practice address
618 8TH ST, BALDWIN CITY, KS 66006-6009
(785) 594-8424
(785) 594-8465
Mailing address
3613 PARKVIEW CT, LAWRENCE, KS 66049-3322
(785) 843-8078

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00002-24
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00002-24
ATHLETIC TRAINER
KS
Enumeration date
07/15/2006
Last updated
03/31/2014
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