Provider Demographics
NPI:1508065889
Name:LYNCH CHIROPRACTIC CENTER,INC
Entity Type:Organization
Organization Name:LYNCH CHIROPRACTIC CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:HARRELD
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-266-1999
Mailing Address - Street 1:2505 LARKIN RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3256
Mailing Address - Country:US
Mailing Address - Phone:859-266-1999
Mailing Address - Fax:
Practice Address - Street 1:2505 LARKIN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3256
Practice Address - Country:US
Practice Address - Phone:859-266-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00479Medicare PIN