Healthcare Provider Details

I. General information

NPI: 1841172657
Provider Name (Legal Business Name): DREW FLYNN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 TURKEYFOOT RD
ELSMERE KY
41018-2838
US

IV. Provider business mailing address

3802 TURKEYFOOT RD
ERLANGER KY
41018-2838
US

V. Phone/Fax

Practice location:
  • Phone: 859-342-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number299967
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: