Provider Demographics
NPI:1699181701
Name:LYNX, RICHARD JOSEPH
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:LYNX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 GLENWOOD AVE
Mailing Address - Street 2:APARTMENT 5
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2026
Mailing Address - Country:US
Mailing Address - Phone:330-423-8559
Mailing Address - Fax:
Practice Address - Street 1:5100 GLENWOOD AVE
Practice Address - Street 2:APARTMENT 5
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2026
Practice Address - Country:US
Practice Address - Phone:330-423-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide