Healthcare Provider Details

I. General information

NPI: 1023052313
Provider Name (Legal Business Name): DEBRA FLYNN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 KENNEDY DR SUITE 401
KEY WEST FL
33040-4134
US

IV. Provider business mailing address

1010 KENNEDY DR SUITE 401
KEY WEST FL
33040-4134
US

V. Phone/Fax

Practice location:
  • Phone: 305-296-5626
  • Fax: 305-293-0010
Mailing address:
  • Phone: 305-296-5626
  • Fax: 305-293-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH2917
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: