Provider Demographics
NPI:1285839811
Name:LYNN'S PERFECT FIT
Entity Type:Organization
Organization Name:LYNN'S PERFECT FIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:REDDICK
Authorized Official - Suffix:
Authorized Official - Credentials:CFM
Authorized Official - Phone:901-546-7572
Mailing Address - Street 1:2838 HICKORY HILL RD
Mailing Address - Street 2:28
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2173
Mailing Address - Country:US
Mailing Address - Phone:901-546-7572
Mailing Address - Fax:901-546-7572
Practice Address - Street 1:2838 HICKORY HILL RD
Practice Address - Street 2:SUITE 28
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-2173
Practice Address - Country:US
Practice Address - Phone:901-546-7572
Practice Address - Fax:901-546-7572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCFM01423335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier