Provider Demographics
NPI:1609086958
Name:LYNCH CHIROPRACTIC PC
Entity Type:Organization
Organization Name:LYNCH CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-890-1123
Mailing Address - Street 1:289 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4389
Mailing Address - Country:US
Mailing Address - Phone:603-890-1123
Mailing Address - Fax:603-890-1123
Practice Address - Street 1:289 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4389
Practice Address - Country:US
Practice Address - Phone:603-890-1123
Practice Address - Fax:603-890-1123
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LYNCH CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-23
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH279-0297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0504357Y0NH02OtherANTHEM
NH80004339Medicaid
MAY39822OtherBLUE CROSS BLUE SHIELD
MAY39822OtherBLUE CROSS BLUE SHIELD
NH80004339Medicaid