MEDICARE: LAURA ANN FLYNN PT, PCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	PT0000007153	TN

General Provider Information

NPI Number	:	1437330313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ANN FLYNN PT, PCS

Provider Business Mailing Address
First Line	:	1301 22ND AVENUE SOUTH
Second Line	:	1702 TVC
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0001
Country	:	US
Telephone Number	:	615-343-6445
Fax Number	:	615-343-0506

Provider Business Practice Location Address
First Line	:	1301 22ND AVENUE SOUTH
Second Line	:	1702 TVC
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0001
Country	:	US
Telephone Number	:	615-343-6445
Fax Number	:	615-343-0506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	11/19/2007

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