Basic Information
| Provider Information | |||||||||
| NPI: | 1932543055 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLYNN | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 CORPORATE DR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178392188 | ||||||||
| FaxNumber: | 7177734654 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 S ADAMS ST | ||||||||
| Address2: | |||||||||
| City: | FULTON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 388438952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6628624104 | ||||||||
| FaxNumber: | 6628624162 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2013 | ||||||||
| LastUpdateDate: | 09/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT3189 | MS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.