Provider Demographics
NPI:1235323411
Name:FLYNN, PATRICIA M (DC DABCO)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:FLYNN
Suffix:
Gender:F
Credentials:DC DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13050 W RANCHO SANTA FE BLVD
Mailing Address - Street 2:SUITE B-5
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-1756
Mailing Address - Country:US
Mailing Address - Phone:623-535-8984
Mailing Address - Fax:623-535-9892
Practice Address - Street 1:13050 W RANCHO SANTA FE BLVD
Practice Address - Street 2:SUITE B-5
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1756
Practice Address - Country:US
Practice Address - Phone:623-535-8984
Practice Address - Fax:623-535-9892
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7837 , 4527 PHYSIO111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor