Provider Demographics
NPI:1467789479
Name:FLYNN, LEAH MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:FLYNN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S LINDEN RD
Mailing Address - Street 2:STE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5475
Mailing Address - Country:US
Mailing Address - Phone:888-218-4045
Mailing Address - Fax:810-249-4230
Practice Address - Street 1:2222 S LINDEN RD
Practice Address - Street 2:STE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5475
Practice Address - Country:US
Practice Address - Phone:888-218-4045
Practice Address - Fax:810-249-4230
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist