Provider Demographics
NPI:1144429036
Name:AUBUCHON, LYNN M (PT)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:M
Last Name:AUBUCHON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25755 LAKE AMELIA WAY
Mailing Address - Street 2:#103
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-3838
Mailing Address - Country:US
Mailing Address - Phone:207-431-3806
Mailing Address - Fax:
Practice Address - Street 1:25755 LAKE AMELIA WAY
Practice Address - Street 2:#103
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-3838
Practice Address - Country:US
Practice Address - Phone:207-431-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT645172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist