Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 023398 | NY |
NPI | 1003185711 |
---|---|
Provider Name | Dr. William Douglas Lynch |
First Address | Goshen, NY 10924-6709 |
Second Address | Goshen, NY 10924-6709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2011 |
Last Update Date | 26/12/2011 |