Provider Demographics
NPI:1003401829
Name:TOOMBS, LYNNAE
Entity Type:Individual
Prefix:
First Name:LYNNAE
Middle Name:
Last Name:TOOMBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 BOURDON BELL DR SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-7456
Mailing Address - Country:US
Mailing Address - Phone:404-630-1811
Mailing Address - Fax:
Practice Address - Street 1:1482 BOURDON BELL DR SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-7456
Practice Address - Country:US
Practice Address - Phone:404-630-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor