Provider Demographics
NPI:1679940712
Name:FLYNN BROWN CHIROPRACTIC, SC
Entity type:Organization
Organization Name:FLYNN BROWN CHIROPRACTIC, SC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-600-2540
Mailing Address - Street 1:1405 78TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55386-9723
Mailing Address - Country:US
Mailing Address - Phone:952-443-3710
Mailing Address - Fax:952-443-3761
Practice Address - Street 1:1405 78TH ST STE 100
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:MN
Practice Address - Zip Code:55386-9723
Practice Address - Country:US
Practice Address - Phone:952-443-3710
Practice Address - Fax:952-443-3761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5437111N00000X
MN5451111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty