National Provider Identifier Database

THE LYMPHEDEMOBILE PLLC
Health Service


Contact Information

THE LYMPHEDEMOBILE PLLC
4446 E JOEY AVE
FLAGSTAFF, AZ86004-2415
Phone: 928-221-9632
Fax:
Website:
Specialty Taxonomy Code
* Health Service 261QH0100X

* Indicates primary specialty

NPI Profile & details for THE LYMPHEDEMOBILE PLLC

NPI Number 1730613886
Legal business name
LBN
THE LYMPHEDEMOBILE PLLC
Authorized official REGINA EASON - (OWNER/MANAGER)
Entity Organization
Organization subpart No
Enumeration date 04/16/2017
Last updated 04/16/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: 5556

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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