Healthcare Provider Details

I. General information

NPI: 1326218934
Provider Name (Legal Business Name): WALSH CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 AIRPORT RD STE 103
MILFORD DE
19963-6421
US

IV. Provider business mailing address

800 AIRPORT RD STE 103
MILFORD DE
19963-6421
US

V. Phone/Fax

Practice location:
  • Phone: 302-422-0622
  • Fax: 302-422-0520
Mailing address:
  • Phone: 302-422-0622
  • Fax: 302-422-0520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF1-0000180
License Number StateDE

VIII. Authorized Official

Name: DR. LYNN EDGAR WALSH
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 302-422-0622