Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 13735 | NC |
N | 225100000X | Physical Therapist | 7640 | SC |
NPI | 1003163346 |
---|---|
Provider Name | Dr. Kristin Lynch |
First Address | Fort Mill, SC 29708-8985 |
Second Address | Fort Mill, SC 29708-8985 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2012 |
Last Update Date | 12/05/2016 |