Healthcare Provider Details

I. General information

NPI: 1477427276
Provider Name (Legal Business Name): PATRICK FLYNN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 FORUM DR STE 2
COLUMBIA SC
29229-7950
US

IV. Provider business mailing address

110 FORUM DR STE 2
COLUMBIA SC
29229-7950
US

V. Phone/Fax

Practice location:
  • Phone: 803-462-3535
  • Fax:
Mailing address:
  • Phone: 803-462-3535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number0773
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: