Provider Demographics
NPI:1629507165
Name:LYNCH, RAYMOND LOUIS (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LOUIS
Last Name:LYNCH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 LAURI LN
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-5074
Mailing Address - Country:US
Mailing Address - Phone:706-566-3922
Mailing Address - Fax:
Practice Address - Street 1:6053 VETERANS PKWY STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-4663
Practice Address - Country:US
Practice Address - Phone:706-786-6530
Practice Address - Fax:706-786-6535
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist