Healthcare Provider Details

I. General information

NPI: 1285499327
Provider Name (Legal Business Name): MR. DANIEL JOSEPH FLYNN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 BLUE SPRUCE CT
DELAWARE OH
43015-4005
US

IV. Provider business mailing address

162 CHARLES RD SW
PATASKALA OH
43062-9254
US

V. Phone/Fax

Practice location:
  • Phone: 614-226-8484
  • Fax:
Mailing address:
  • Phone: 614-822-6173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: