Provider Demographics
NPI:1891724308
Name:LYNN, KAREN M (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:LYNN
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 1:511 INDIA RD
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-2920
Mailing Address - Country:US
Mailing Address - Phone:333-703-0358
Mailing Address - Fax:
Practice Address - Street 1:2140 E UNIVERSITY DR
Practice Address - Street 2:STE J
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-1851
Practice Address - Country:US
Practice Address - Phone:334-321-0601
Practice Address - Fax:334-321-0605
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 2212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-29799OtherBCBS PROVIDER
AL051529800Medicare PIN
ALS40655Medicare UPIN
AL051529800Medicare ID - Type Unspecified