Provider Demographics
NPI:1235560483
Name:FLINNER, JUSTIN (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:FLINNER
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7741 INVERSHAM DR APT 188
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-4489
Mailing Address - Country:US
Mailing Address - Phone:703-635-0712
Mailing Address - Fax:
Practice Address - Street 1:910 17TH ST NW
Practice Address - Street 2:SUITE 1020
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2601
Practice Address - Country:US
Practice Address - Phone:202-505-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500184171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist