Provider Demographics
NPI:1376733303
Name:LYNCH, DOUGLAS (DC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10723 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5636
Mailing Address - Country:US
Mailing Address - Phone:623-848-6991
Mailing Address - Fax:623-848-6993
Practice Address - Street 1:10723 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5636
Practice Address - Country:US
Practice Address - Phone:623-848-6991
Practice Address - Fax:623-848-6993
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7841111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor