Provider Demographics
NPI:1750858429
Name:BREWER, LYNNZ MORGYNN (ATC)
Entity Type:Individual
Prefix:MR
First Name:LYNNZ
Middle Name:MORGYNN
Last Name:BREWER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HEATH ST APT 75
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-3135
Mailing Address - Country:US
Mailing Address - Phone:803-412-9110
Mailing Address - Fax:
Practice Address - Street 1:800 HEATH ST APT 75
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-3135
Practice Address - Country:US
Practice Address - Phone:803-412-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer