Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1427 | MA |
NPI | 1003921750 |
---|---|
Provider Name | Mr. James Joseph Lynch III |
First Address | Northborough, MA 01532 |
Second Address | Northborough, MA 01532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Y36009 | (05) | MA |