Healthcare Provider Details

I. General information

NPI: 1154475481
Provider Name (Legal Business Name): EMILY N FLYNN PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 GREENO RD S
FAIRHOPE AL
36532-1902
US

IV. Provider business mailing address

243 GREENO RD S
FAIRHOPE AL
36532-1902
US

V. Phone/Fax

Practice location:
  • Phone: 251-928-3909
  • Fax: 251-928-3984
Mailing address:
  • Phone: 251-928-3909
  • Fax: 251-928-3984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10910
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH5773
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: