Provider Demographics
NPI:1841365087
Name:FLYNN, RORY WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:RORY
Middle Name:WILLIAM
Last Name:FLYNN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5234 NEWPARK PLAZA
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560
Mailing Address - Country:US
Mailing Address - Phone:510-739-3550
Mailing Address - Fax:510-739-3554
Practice Address - Street 1:5234 NEWPARK PLAZA
Practice Address - Street 2:SUITE B
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560
Practice Address - Country:US
Practice Address - Phone:510-739-3550
Practice Address - Fax:510-739-3554
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 21970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor