Provider Demographics
NPI:1821133562
Name:FLAHIVE, ELIZABETH ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:FLAHIVE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:BEA
Other - Middle Name:
Other - Last Name:FLAHIVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:2216 HAWK DR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-6270
Mailing Address - Country:US
Mailing Address - Phone:563-332-9653
Mailing Address - Fax:
Practice Address - Street 1:729 21ST ST
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-5004
Practice Address - Country:US
Practice Address - Phone:563-344-6268
Practice Address - Fax:563-359-5967
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25100000X251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)