Provider Demographics
NPI:1134366271
Name:MABRY, LYNN K (DC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:K
Last Name:MABRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 PROSPERITY FARMS RD STE D223
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3491
Mailing Address - Country:US
Mailing Address - Phone:561-758-0177
Mailing Address - Fax:
Practice Address - Street 1:11211 PROSPERITY FARMS RD STE D223
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3491
Practice Address - Country:US
Practice Address - Phone:504-931-7444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9797111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor