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Individual

KELLY DIANE FLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1575 S WASHINGTON ST, CRAWFORDSVILLE, IN 47933
(765) 230-3539
(765) 267-2156
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6250

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007005A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000017528
ANTHEM BCBS PIN NUMBER
IN
05
200326490
IN
Enumeration date
11/03/2006
Last updated
10/11/2019
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