Provider Demographics
NPI:1669726568
Name:LYNCH, DARON KEITH (DC)
Entity type:Individual
Prefix:DR
First Name:DARON
Middle Name:KEITH
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5529 W STATE ROAD 10
Mailing Address - Street 2:
Mailing Address - City:DEMOTTE
Mailing Address - State:IN
Mailing Address - Zip Code:46310-8799
Mailing Address - Country:US
Mailing Address - Phone:219-987-7746
Mailing Address - Fax:
Practice Address - Street 1:5529 W STATE ROAD 10
Practice Address - Street 2:
Practice Address - City:DEMOTTE
Practice Address - State:IN
Practice Address - Zip Code:46310-8799
Practice Address - Country:US
Practice Address - Phone:219-987-7746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002681A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor