Holly Sue Flynn, LMP

Individual provider Active NPI Contractor · Port Orchard, WA

NPI 1003008863 · NPPES record last updated Aug 15, 2007

Key facts

NPI
1003008863
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
MA00014461 (WA)
Practice address
1963 Bethel Rd SE
Port Orchard, WA 98366-3108
Phone
(360) 710-7747
Fax
(360) 895-0447
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA00014461WAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Health Center Inc PS Past
since Jul 1, 2010
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X MA00014461 WA Yes

Addresses

Primary practice location

1963 Bethel Rd SE
Port Orchard, WA 98366-3108

Mailing address

PO Box 1222
Port Orchard, WA 98366
Phone (360) 710-7747

Other providers in Port Orchard, WA

All providers in Port Orchard, WA · Contractor in Washington

Sources for this page

Verify at the official NPI Registry.