Healthcare Provider Details

I. General information

NPI: 1659336907
Provider Name (Legal Business Name): JEFFREY ALAN LYNN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 E GREENWAY RD SUITE 1
PHOENIX AZ
85032-4797
US

IV. Provider business mailing address

4022 E GREENWAY RD SUITE 1
PHOENIX AZ
85032-4798
US

V. Phone/Fax

Practice location:
  • Phone: 602-493-0004
  • Fax:
Mailing address:
  • Phone: 602-493-0004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7693
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number7693
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: