Provider Demographics
NPI:1861764524
Name:LYNCH CHIROPRACTIC ARTS CENTER, LLC
Entity type:Organization
Organization Name:LYNCH CHIROPRACTIC ARTS CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:207-799-2263
Mailing Address - Street 1:1200 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5652
Mailing Address - Country:US
Mailing Address - Phone:207-799-2263
Mailing Address - Fax:207-799-7112
Practice Address - Street 1:1200 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5652
Practice Address - Country:US
Practice Address - Phone:207-799-2263
Practice Address - Fax:207-799-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty