Provider Demographics
NPI:1699851253
Name:LYNOTT CHIROPRACTIC INC
Entity Type:Organization
Organization Name:LYNOTT CHIROPRACTIC INC
Other - Org Name:LYNOTT CHIROPRACTIC & ACUPUNCTURE, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIAL
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:LYNOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:562-594-6644
Mailing Address - Street 1:5512 E BRITTON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3146
Mailing Address - Country:US
Mailing Address - Phone:562-594-6644
Mailing Address - Fax:562-594-6114
Practice Address - Street 1:5512 E BRITTON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3146
Practice Address - Country:US
Practice Address - Phone:562-594-6644
Practice Address - Fax:562-594-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19647Medicare PIN