Provider Demographics
NPI:1710211339
Name:FLAH, JAMES DORBOR (PCA/NAR)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DORBOR
Last Name:FLAH
Suffix:
Gender:M
Credentials:PCA/NAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 36TH AVE N
Mailing Address - Street 2:#319
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1975
Mailing Address - Country:US
Mailing Address - Phone:612-644-5769
Mailing Address - Fax:
Practice Address - Street 1:8015 36TH AVE N
Practice Address - Street 2:#319
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1975
Practice Address - Country:US
Practice Address - Phone:612-644-5769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide