Provider Demographics
NPI:1306660840
Name:CANTU, LYNN (DC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:CANTU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:LY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3306 US HIGHWAY 19 STE B
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-1846
Mailing Address - Country:US
Mailing Address - Phone:813-625-2559
Mailing Address - Fax:
Practice Address - Street 1:3306 US HIGHWAY 19 STE B
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-1846
Practice Address - Country:US
Practice Address - Phone:813-625-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor