Provider Demographics
NPI:1235900887
Name:LYNN FAMILY EYECARE PC
Entity Type:Organization
Organization Name:LYNN FAMILY EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-778-4728
Mailing Address - Street 1:2903 NEWBERRY WAY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7333
Mailing Address - Country:US
Mailing Address - Phone:678-778-4728
Mailing Address - Fax:
Practice Address - Street 1:4166 JIMMY LEE SMITH PKWY
Practice Address - Street 2:SUITE G
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3289
Practice Address - Country:US
Practice Address - Phone:770-439-4230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty