Individual
HEATHER M FLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
653 W STEPHENSON ST, FREEPORT, IL 61032-5005
(815) 232-7575
Mailing address
143 E POPLAR DR, ELIZABETH, IL 61028-9761
(815) 858-3783
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08932005
BCBS PROVIDER #
IL
Enumeration date
04/04/2007
Last updated
07/09/2007
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