Provider Demographics
NPI:1952646713
Name:LYNCH, LISA LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:LOUISE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2310
Mailing Address - Country:US
Mailing Address - Phone:408-357-3371
Mailing Address - Fax:408-442-3946
Practice Address - Street 1:1585 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2310
Practice Address - Country:US
Practice Address - Phone:408-249-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 32231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor