Provider Demographics
NPI:1588752976
Name:FLYNN, TIMOTHY WILLIAM (PT, PHD, OCS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:WILLIAM
Last Name:FLYNN
Suffix:
Gender:M
Credentials:PT, PHD, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W MAGNOLIA ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2915
Mailing Address - Country:US
Mailing Address - Phone:970-221-1201
Mailing Address - Fax:
Practice Address - Street 1:210 W MAGNOLIA ST
Practice Address - Street 2:SUITE 110
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2915
Practice Address - Country:US
Practice Address - Phone:970-221-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO72722251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic