MEDICARE: MR. CHRIS FLANARY

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1922548353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRIS FLANARY

Provider Business Mailing Address
First Line	:	10700 S CHOCTAW RD
Second Line	:
City	:	NEWALLA
State	:	OK
Zip	:	74857-7962
Country	:	US
Telephone Number	:	405-301-3789
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 SE GRAND BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73129-6732
Country	:	US
Telephone Number	:	405-672-7893
Fax Number	:

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

Provider Enumeration Date	:	03/05/2017
Last Update Date	:	03/05/2017

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Directions to “ MR. CHRIS FLANARY ” Practice Location

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