Provider Demographics
NPI:1669771077
Name:FLINT, ADAM (PT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
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 1:11650 ROCK LAKE TER
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-7824
Mailing Address - Country:US
Mailing Address - Phone:561-247-1824
Mailing Address - Fax:
Practice Address - Street 1:11650 ROCK LAKE TER
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33473-7824
Practice Address - Country:US
Practice Address - Phone:561-247-1824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist