Provider Demographics
NPI:1568475499
Name:BRAUN, LYNN M (PT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:BRAUN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:M
Other - Last Name:PULVERMACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6316 HELLENBRAND RD
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-9599
Mailing Address - Country:US
Mailing Address - Phone:608-849-9212
Mailing Address - Fax:
Practice Address - Street 1:1001 ARBORETUM DR
Practice Address - Street 2:SUITE 1-A
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-2670
Practice Address - Country:US
Practice Address - Phone:608-850-6181
Practice Address - Fax:608-850-6121
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2448-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist