Provider Demographics
NPI:1356311625
Name:FLYNN, MICHAEL C (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:FLYNN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3344 ROUTE 130 STE C
Mailing Address - Street 2:
Mailing Address - City:HARRISON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15636-1238
Mailing Address - Country:US
Mailing Address - Phone:412-522-8251
Mailing Address - Fax:412-374-1416
Practice Address - Street 1:3344 ROUTE 130 STE C
Practice Address - Street 2:
Practice Address - City:HARRISON CITY
Practice Address - State:PA
Practice Address - Zip Code:15636-1238
Practice Address - Country:US
Practice Address - Phone:412-522-8251
Practice Address - Fax:412-374-1416
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006019L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1659088Medicaid
PA791871Medicare ID - Type UnspecifiedMEDICARE
PAU57324Medicare UPIN