1184099814 NPI number — SARA KATHERINE LYNCH MS, ATC, LAT

Table of content: SARA KATHERINE LYNCH MS, ATC, LAT (NPI 1184099814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184099814 NPI number — SARA KATHERINE LYNCH MS, ATC, LAT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
SARA
Provider Middle Name:
KATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, ATC, LAT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184099814
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
723 MAPLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALLADEGA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35160-2812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5291 VALLEYDALE RD
Provider Second Line Business Practice Location Address:
SUITE 113
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-7705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-453-4658
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com