Provider Demographics
NPI:1689787400
Name:FLINT, LAURA M (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:FLINT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:P O BOX 1356
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-1356
Mailing Address - Country:US
Mailing Address - Phone:843-650-4461
Mailing Address - Fax:843-651-3102
Practice Address - Street 1:325 WELLNESS DR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-6708
Practice Address - Country:US
Practice Address - Phone:843-650-4461
Practice Address - Fax:843-903-6109
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC3892225100000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1084Medicaid
SCQ32429Medicare UPIN
SCTH1084Medicaid
SC5419450001Medicare NSC