Individual
DEREK FLINTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4896 MAIN ST STE 201, JASPER, TN 37347-3682
(423) 269-2608
Mailing address
4896 MAIN ST STE 201, JASPER, TN 37347-3682
(423) 269-2608
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11111111111111
PRIVATE PAY/ VA
TN
Enumeration date
02/22/2023
Last updated
02/22/2023
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