Provider Demographics
NPI:1770280240
Name:CELCOR CORPORATION
Entity type:Organization
Organization Name:CELCOR CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CELEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-774-8190
Mailing Address - Street 1:3724 WARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3954
Mailing Address - Country:US
Mailing Address - Phone:330-607-6631
Mailing Address - Fax:
Practice Address - Street 1:6425 WILKINSON BLVD.
Practice Address - Street 2:SUITE D
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2801
Practice Address - Country:US
Practice Address - Phone:704-774-8190
Practice Address - Fax:704-774-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty