Provider Demographics
NPI:1447813951
Name:FLIGG, MICHAEL BRETT
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BRETT
Last Name:FLIGG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15005 QUINCE CT
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8328
Mailing Address - Country:US
Mailing Address - Phone:720-505-7077
Mailing Address - Fax:
Practice Address - Street 1:15005 QUINCE CT
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-8328
Practice Address - Country:US
Practice Address - Phone:720-505-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12612OtherPHYSICAL THERAPY ASSIST