Basic Information
| Provider Information | |||||||||
| NPI: | 1174639900 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLAMM | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9015 OLD HIGHWAY 51 N | ||||||||
| Address2: | |||||||||
| City: | COBDEN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629203047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184570465 | ||||||||
| FaxNumber: | 6184578022 | ||||||||
| Practice Location | |||||||||
| Address1: | 202 W JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | CARBONDALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629011409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184570465 | ||||||||
| FaxNumber: | 6184578022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471S1302X | IL | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Sonography |
No ID Information.