Provider Demographics
NPI:1366806648
Name:FLANERY, ALICIA THERESE (MED)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:THERESE
Last Name:FLANERY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 NEEDMORE RD
Mailing Address - Street 2:APT. 22
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6275
Mailing Address - Country:US
Mailing Address - Phone:865-603-9311
Mailing Address - Fax:
Practice Address - Street 1:770 NEEDMORE RD
Practice Address - Street 2:APT 22
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6275
Practice Address - Country:US
Practice Address - Phone:865-603-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other