Provider Demographics
NPI:1982809265
Name:FLAGG, JOHN FLETCHER (ATC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FLETCHER
Last Name:FLAGG
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHELSEA CT
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-8030
Mailing Address - Country:US
Mailing Address - Phone:410-251-4624
Mailing Address - Fax:
Practice Address - Street 1:1 CHELSEA CT
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-8030
Practice Address - Country:US
Practice Address - Phone:410-251-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer