Healthcare Provider Details

I. General information

NPI: 1306287206
Provider Name (Legal Business Name): LYNCH CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 07/09/2013
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

419 N GRANDVIEW AVE
DUBUQUE IA
52001-6363
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: DR. PETER HARLAND LYNCH
Title or Position: CHIROPRACTOR
Credential: D.O.
Phone: 563-564-8198