Provider Demographics
NPI:1730808726
Name:LYNCH, SARAH JEAN (DC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JEAN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:HEESACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2420 FINGER RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54302-4210
Mailing Address - Country:US
Mailing Address - Phone:920-465-6040
Mailing Address - Fax:920-465-4464
Practice Address - Street 1:2420 FINGER RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54302-4210
Practice Address - Country:US
Practice Address - Phone:920-465-6040
Practice Address - Fax:920-465-4464
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5766-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor