Healthcare Provider Details

I. General information

NPI: 1538273610
Provider Name (Legal Business Name): MICHAEL FLYNN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W. CARMEL DRIVE SUITE 212
CARMEL IN
46032
US

IV. Provider business mailing address

160 W. CARMEL DRIVE SUITE 212
CARMEL IN
46032
US

V. Phone/Fax

Practice location:
  • Phone: 317-580-1145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001549A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: