Provider Demographics
NPI:1225605488
Name:TATARCZUK, LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:TATARCZUK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMPTON RD UNIT 304
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4849
Mailing Address - Country:US
Mailing Address - Phone:603-775-7855
Mailing Address - Fax:603-775-7955
Practice Address - Street 1:1 HAMPTON RD UNIT 304
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4849
Practice Address - Country:US
Practice Address - Phone:603-775-7855
Practice Address - Fax:603-775-7955
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2262M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist