Provider Demographics
NPI:1861057762
Name:FLANNAGAN, REBECCA (DC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FLANNAGAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TOWN SQ UNIT 130
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180-8556
Mailing Address - Country:US
Mailing Address - Phone:540-668-5837
Mailing Address - Fax:703-421-2822
Practice Address - Street 1:20 TOWN SQ UNIT 130
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-8556
Practice Address - Country:US
Practice Address - Phone:540-668-5837
Practice Address - Fax:703-421-2822
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0104557573OtherSTATE LICENSE