MEDICARE: PATRICIA M FLYNN DC DABCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7837 , 4527 PHYSIO	AZ

General Provider Information

NPI Number	:	1235323411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA M FLYNN DC DABCO

Provider Business Mailing Address
First Line	:	13050 W RANCHO SANTA FE BLVD
Second Line	:	SUITE B-5
City	:	AVONDALE
State	:	AZ
Zip	:	85392-1756
Country	:	US
Telephone Number	:	623-535-8984
Fax Number	:	623-535-9892

Provider Business Practice Location Address
First Line	:	13050 W RANCHO SANTA FE BLVD
Second Line	:	SUITE B-5
City	:	AVONDALE
State	:	AZ
Zip	:	85392-1756
Country	:	US
Telephone Number	:	623-535-8984
Fax Number	:	623-535-9892

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	08/30/2007

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