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Lynette Kline
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NPI Number Detailed Information
Provider Information:
| Name: | Lynette Kline |
| Gender: | F |
| Provider License Number If Given: | 9506 |
NPI Information:
| NPI: | 1881688380 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 5/5/2016 |
Provider Business Mailing Address:
| Address: | 510 CYPRESS ST STE A Fort Bragg, CA 95437 |
| Phone Number: | 7079611037 |
| Fax Number: |
Provider Business Practice Location Address:
| Address: | 510 CYPRESS ST STE A Fort Bragg, CA 95437 |
| Phone Number: | 7079611037 |
| Fax Number: | 7079610346 |
Provider Taxonomy:
| Primary: | 152W00000X |
| Secondary (if any): | |
| State: | CA |
