Provider Demographics
NPI:1346556974
Name:FLYNN, JESSICA LEIGH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LEIGH
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15940 SANDWAVE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7381
Mailing Address - Country:US
Mailing Address - Phone:804-731-9647
Mailing Address - Fax:
Practice Address - Street 1:320B CHARLES H DIMMOCK PKWY
Practice Address - Street 2:SUITE 6
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2938
Practice Address - Country:US
Practice Address - Phone:804-524-0533
Practice Address - Fax:804-524-0133
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206606225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist