Provider Demographics
NPI:1992012421
Name:FLYNT, ROSS MILEY (PT)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:MILEY
Last Name:FLYNT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3980 NEW COVINGTON PIKE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2500
Mailing Address - Country:US
Mailing Address - Phone:901-937-3200
Mailing Address - Fax:901-383-1738
Practice Address - Street 1:3980 NEW COVINGTON PIKE
Practice Address - Street 2:SUITE 108
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2500
Practice Address - Country:US
Practice Address - Phone:901-937-3200
Practice Address - Fax:901-383-1738
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN8784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist