Provider Demographics
NPI:1336663939
Name:FLINT, SPENCER PAUL
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:PAUL
Last Name:FLINT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 ALLISON BONNETT MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-1859
Mailing Address - Country:US
Mailing Address - Phone:205-545-9905
Mailing Address - Fax:205-545-9969
Practice Address - Street 1:2801 ALLISON BONNETT MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-1859
Practice Address - Country:US
Practice Address - Phone:205-545-9905
Practice Address - Fax:205-545-9969
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist