Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 8480 | MA |
NPI | 1134425911 |
---|---|
Provider Name | Ms. Jannelle Marie Flynn |
First Address | Weymouth, MA 02188-2336 |
Second Address | Weymouth, MA 02188-2336 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2011 |
Last Update Date | 27/01/2011 |