Healthcare Provider Details

I. General information

NPI: 1952408676
Provider Name (Legal Business Name): RONALD F FLYNN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 HIGHWAY 44 E
SHEPHERDSVILLE KY
40165-5128
US

IV. Provider business mailing address

559 LICKSKILLET DR
SHEPHERDSVILLE KY
40165-9312
US

V. Phone/Fax

Practice location:
  • Phone: 502-955-5328
  • Fax:
Mailing address:
  • Phone: 502-921-1265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4023
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: