Healthcare Provider Details

I. General information

NPI: 1235323411
Provider Name (Legal Business Name): PATRICIA M FLYNN DC DABCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13050 W RANCHO SANTA FE BLVD SUITE B-5
AVONDALE AZ
85392-1756
US

IV. Provider business mailing address

13050 W RANCHO SANTA FE BLVD SUITE B-5
AVONDALE AZ
85392-1756
US

V. Phone/Fax

Practice location:
  • Phone: 623-535-8984
  • Fax: 623-535-9892
Mailing address:
  • Phone: 623-535-8984
  • Fax: 623-535-9892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7837 , 4527 PHYSIO
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: