Basic Information
| Provider Information | |||||||||
| NPI: | 1295250074 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LYNCH | ||||||||
| FirstName: | DANICA | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 COMMERCE WAY | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | PORTSMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038018200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034278066 | ||||||||
| FaxNumber: | 6035010495 | ||||||||
| Practice Location | |||||||||
| Address1: | 607 BOYLSTON ST FL 4 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021163604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8573504544 | ||||||||
| FaxNumber: | 8573504538 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 225100000X | 23061 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.