Provider Demographics
NPI:1134970460
Name:FLEX
Entity type:Organization
Organization Name:FLEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-737-1234
Mailing Address - Street 1:5859 3 MILE RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-9090
Mailing Address - Country:US
Mailing Address - Phone:989-737-1234
Mailing Address - Fax:
Practice Address - Street 1:107 N HENRY ST BAY CITY
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-4737
Practice Address - Country:US
Practice Address - Phone:989-737-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IRON GORILLA GYM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty