Provider Demographics
NPI:1174639900
Name:FLAMM, LYNN M
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:FLAMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 OLD HIGHWAY 51 N
Mailing Address - Street 2:
Mailing Address - City:COBDEN
Mailing Address - State:IL
Mailing Address - Zip Code:62920-3047
Mailing Address - Country:US
Mailing Address - Phone:618-457-0465
Mailing Address - Fax:618-457-8022
Practice Address - Street 1:202 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-1409
Practice Address - Country:US
Practice Address - Phone:618-457-0465
Practice Address - Fax:618-457-8022
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography