Healthcare Provider Details

I. General information

NPI: 1104935089
Provider Name (Legal Business Name): MARK HERBERT FLYNN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 DELAWARE AVE
OAKMONT PA
15139-2016
US

IV. Provider business mailing address

229 DELAWARE AVE
OAKMONT PA
15139-2016
US

V. Phone/Fax

Practice location:
  • Phone: 412-828-8700
  • Fax: 412-828-9755
Mailing address:
  • Phone: 412-828-8700
  • Fax: 412-828-9755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC003619L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: