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General NPI Number Information
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NPI Number | 1245447747
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Entity Type | Individual
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Provider Name | KEITH PATRICK LYNCH D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 1410 INCARNATION DR STE 202C
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-5708
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Country | US
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Telephone | 434-245-8456
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Fax | 434-245-8457
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Provider Business Mailing Address
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Address Line | 136 BUFFALO RUN RD
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City | STANARDSVILLE
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State | VA
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Zip | 22973-3659
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Country | US
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Telephone | 434-985-6094
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Fax | 434-245-8456
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104 001987
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License Number State | VA
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