Provider Demographics
NPI:1922644681
Name:APEXNETWORK WELLTON LLC
Entity Type:Organization
Organization Name:APEXNETWORK WELLTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/COO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAVEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-651-0444
Mailing Address - Street 1:15 APEX DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1282
Mailing Address - Country:US
Mailing Address - Phone:618-651-0444
Mailing Address - Fax:
Practice Address - Street 1:28873 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:WELLTON
Practice Address - State:AZ
Practice Address - Zip Code:85356-7058
Practice Address - Country:US
Practice Address - Phone:928-785-4977
Practice Address - Fax:928-785-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy