Provider Demographics
NPI:1801334768
Name:FLINT, TIMOTHY II (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:FLINT
Suffix:II
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 S EDMONDS LN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3524
Mailing Address - Country:US
Mailing Address - Phone:469-834-1926
Mailing Address - Fax:
Practice Address - Street 1:797 S OLD ORCHARD LN
Practice Address - Street 2:APT 2029
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4396
Practice Address - Country:US
Practice Address - Phone:469-834-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT041616225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist