Provider Demographics
NPI:1407442767
Name:FLINNER, LARRY LEE III
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:LEE
Last Name:FLINNER
Suffix:III
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 1:1007 RAGERSVILLE RD NW
Mailing Address - Street 2:
Mailing Address - City:SUGARCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:44681-7988
Mailing Address - Country:US
Mailing Address - Phone:330-243-3785
Mailing Address - Fax:
Practice Address - Street 1:1007 RAGERSVILLE RD NW
Practice Address - Street 2:
Practice Address - City:SUGARCREEK
Practice Address - State:OH
Practice Address - Zip Code:44681-7988
Practice Address - Country:US
Practice Address - Phone:330-243-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty