Healthcare Provider Details

I. General information

NPI: 1376065227
Provider Name (Legal Business Name): AINSLEY FLYNN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

957 W 21ST ST STE F
NORFOLK VA
23517-1536
US

IV. Provider business mailing address

400 W OLNEY RD STE E
NORFOLK VA
23507-1864
US

V. Phone/Fax

Practice location:
  • Phone: 757-305-9996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104-557430
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: