Healthcare Provider Details

I. General information

NPI: 1053167411
Provider Name (Legal Business Name): FLYNN CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 W JAMES ST STE 101
KENT WA
98032-4606
US

IV. Provider business mailing address

1042 W JAMES ST STE 101
KENT WA
98032-4606
US

V. Phone/Fax

Practice location:
  • Phone: 253-852-3770
  • Fax:
Mailing address:
  • Phone: 253-852-3770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY FLYNN
Title or Position: OWNER
Credential: DC
Phone: 253-852-3770