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General NPI Number Information
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NPI Number | 1811470875
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Entity Type | Individual
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Provider Name | JENNIFER J FLYNN MSOM, DIP O.M., R.AC
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Gender | Female
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 696 N MILL ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-1452
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Country | US
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Telephone | 414-403-0150
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Fax |
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Provider Business Mailing Address
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Address Line | 9015 AUSTIN RD
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City | SALINE
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State | MI
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Zip | 48176-9652
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Country | US
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Telephone | 414-403-0150
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 5401000206
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License Number State | MI
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