Provider Demographics
NPI:1700883832
Name:LYNCH, KEVIN W (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:W
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 1:289 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
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH279-0297111N00000X
MA2176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0504357Y0NH02OtherANTHEM BCBS
NH80004339Medicaid
MAY36548OtherBCBS OF MA
U64382Medicare UPIN
MAY36548OtherBCBS OF MA