MEDICARE: DR. TIMOTHY WILLIAM FLYNN PT, PHD, OCS

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	2251X0800X	Orthopedic Physical Therapist	7272	CO

General Provider Information

NPI Number	:	1588752976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY WILLIAM FLYNN PT, PHD, OCS

Provider Business Mailing Address
First Line	:	210 W MAGNOLIA ST
Second Line	:	SUITE 110
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2915
Country	:	US
Telephone Number	:	970-221-1201
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 W MAGNOLIA ST
Second Line	:	SUITE 110
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2915
Country	:	US
Telephone Number	:	970-221-1201
Fax Number	:

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	03/25/2008

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