Provider Demographics
NPI:1730754623
Name:FLANAGAN, JOHN ROSS (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ROSS
Last Name:FLANAGAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 DANVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:HILLSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24343-5423
Mailing Address - Country:US
Mailing Address - Phone:276-730-8205
Mailing Address - Fax:
Practice Address - Street 1:3719 UNION RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8044
Practice Address - Country:US
Practice Address - Phone:704-830-2136
Practice Address - Fax:704-830-2138
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214289225100000X
225100000X
NCP22107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist