Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 34.007002 | OH |
N | 2081S0010X | Sports Medicine | 34-007002 | OH |
N | 213ES0000X | Sports Medicine | 34-007002 | OH |
NPI | 1447568019 |
---|---|
Provider Name | Dr. Lynn Amy Richardson |
First Address | Dayton, OH 45458-4728 |
Second Address | Dayton, OH 45458-4728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2010 |
Last Update Date | 07/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0093366 | (05) | OH |