Provider Demographics
NPI:1649571902
Name:PRATT, LYNETTE R
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:R
Last Name:PRATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-0452
Mailing Address - Country:US
Mailing Address - Phone:435-586-0213
Mailing Address - Fax:435-865-9428
Practice Address - Street 1:170 ALTAMIRA AVE
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:85720
Practice Address - Country:US
Practice Address - Phone:435-586-0213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other