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1275129264
ANTONIO LYNE MCCORMACK
ELIZABETHTOWN, KY
NPI
1275129264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2020-12-14
Last Update Date
2020-12-14
Business Address
ANTONIO LYNE MCCORMACK
107 CRANES ROOST CT
ELIZABETHTOWN, KY 42701-3650
Phone number: 270-765-2605
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Mailing Address
ANTONIO LYNE MCCORMACK
1109 REGENCY WAY APT 1
ELIZABETHTOWN, KY 42701-7134
Phone number: 270-307-4252
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