Provider Demographics
NPI:1366569840
Name:CHRISTL, LYNN (LAC)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:CHRISTL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 CHENNAULT AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-0350
Mailing Address - Country:US
Mailing Address - Phone:550-907-2287
Mailing Address - Fax:
Practice Address - Street 1:1172 CHENNAULT AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-0350
Practice Address - Country:US
Practice Address - Phone:550-907-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10544171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist