Healthcare Provider Details

I. General information

NPI: 1073815171
Provider Name (Legal Business Name): PETER HARLAND LYNCH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 N GRANDVIEW AVE
DUBUQUE IA
52001-6363
US

IV. Provider business mailing address

2295 CARTER RD
DUBUQUE IA
52001-2932
US

V. Phone/Fax

Practice location:
  • Phone: 563-564-8198
  • Fax:
Mailing address:
  • Phone: 563-564-8198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number007356
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: