Provider Demographics
NPI:1508831868
Name:FLYNN, JOHN JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
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 1:13220 STRICKLAND RD
Mailing Address - Street 2:184
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5213
Mailing Address - Country:US
Mailing Address - Phone:919-676-6556
Mailing Address - Fax:919-676-9767
Practice Address - Street 1:13220 STRICKLAND RD
Practice Address - Street 2:184
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5213
Practice Address - Country:US
Practice Address - Phone:919-676-6556
Practice Address - Fax:919-676-9767
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1425111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0194LOtherCNC
NC08415OtherBCBS
NC244422AMedicare ID - Type Unspecified
NCU05848Medicare UPIN