Provider Demographics
NPI:1962508309
Name:FLINT, JOHN CHARLES (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:FLINT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7393 TALL OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4625
Mailing Address - Country:US
Mailing Address - Phone:435-658-2329
Mailing Address - Fax:
Practice Address - Street 1:5405 S 500 E STE 200
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-7421
Practice Address - Country:US
Practice Address - Phone:801-479-0312
Practice Address - Fax:801-479-3364
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1159272401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist