Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2739 | MA |
N | 111NN0400X | Neurology | DC24705 | CA |
NPI | 1548348428 |
---|---|
Provider Name | Dr. Lynn M Carlson |
First Address | Acton, MA 01720-5684 |
Second Address | Acton, MA 01720-5684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 29/12/2012 |