Provider Demographics
NPI:1881440683
Name:FLEXELITE PHYSICAL THERAPY CLINIC AND WELLNESS CENTER INC
Entity type:Organization
Organization Name:FLEXELITE PHYSICAL THERAPY CLINIC AND WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YADILKA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-312-6334
Mailing Address - Street 1:2400 OLD MILTON PKWY UNIT 411
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-1715
Mailing Address - Country:US
Mailing Address - Phone:470-657-3338
Mailing Address - Fax:866-940-3539
Practice Address - Street 1:11080 OLD ROSWELL RD STE 105-106
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-4757
Practice Address - Country:US
Practice Address - Phone:470-657-3338
Practice Address - Fax:866-940-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy