Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist | GA |
NPI | 1467945444 |
---|---|
Provider Name | Lynette Singleton Brown |
First Address | Atlanta, GA 30310-4946 |
Second Address | Atlanta, GA 30337-2841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2018 |
Last Update Date | 13/06/2018 |