Healthcare Provider Details

I. General information

NPI: 1154569150
Provider Name (Legal Business Name): CATHERINE R FLYNN D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 MOUNTAIN VIEW AVE
MARYVILLE TN
37803-4822
US

IV. Provider business mailing address

802 MOUNTAIN VIEW AVE
MARYVILLE TN
37803-4822
US

V. Phone/Fax

Practice location:
  • Phone: 865-681-4111
  • Fax:
Mailing address:
  • Phone: 865-681-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC0000002303
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: