Provider Demographics
NPI:1215359385
Name:KATE LYNCH DC LLC
Entity Type:Organization
Organization Name:KATE LYNCH DC LLC
Other - Org Name:CHIROPRACTIC & SPORTS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY-KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-347-2205
Mailing Address - Street 1:15 SEWALL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2641
Mailing Address - Country:US
Mailing Address - Phone:207-347-2205
Mailing Address - Fax:
Practice Address - Street 1:15 SEWALL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2641
Practice Address - Country:US
Practice Address - Phone:207-347-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1909111NS0005X
WY682111NS0005X
IDCHIA1307111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty