Healthcare Provider Details

I. General information

NPI: 1619869948
Provider Name (Legal Business Name): ELIZABETH FLYNN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16915 DETROIT AVE
LAKEWOOD OH
44107-3620
US

IV. Provider business mailing address

4232 SPRINGVALE CIR
AVON OH
44011-3209
US

V. Phone/Fax

Practice location:
  • Phone: 216-521-8400
  • Fax:
Mailing address:
  • Phone: 440-458-0911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT021757
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: