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General NPI Number Information
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NPI Number | 1184014078
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Entity Type | Individual
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Provider Name | BRIAN F FLYNN LMT
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Gender | Male
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 98 STATE HIGHWAY 150, SUITE 7
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City | EL PARDO
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State | NM
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Zip | 87529-1589
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Country | US
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Telephone | 575-776-1117
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Fax | 575-776-1119
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Provider Business Mailing Address
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Address Line | P.O. BOX 1589
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City | EL PARDO
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State | NM
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Zip | 87529-1589
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Country | US
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Telephone | 575-776-1117
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Fax | 575-776-1119
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7210
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License Number State | NM
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