Provider Demographics
NPI:1841396462
Name:LYNCH, LOUISE F (PT)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:F
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 WATERTOWER CIR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5801
Mailing Address - Country:US
Mailing Address - Phone:802-655-7575
Mailing Address - Fax:802-655-1115
Practice Address - Street 1:441 WATERTOWER CIR
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5801
Practice Address - Country:US
Practice Address - Phone:802-655-7575
Practice Address - Fax:802-655-1115
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0002312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist