Provider Demographics
NPI:1932851821
Name:CELLFLEX THERAPY, LLC
Entity Type:Organization
Organization Name:CELLFLEX THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SR. MANAGMENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-731-7986
Mailing Address - Street 1:6404 ROOSEVELT BLVD.
Mailing Address - Street 2:SUITE #. 1-C-2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149
Mailing Address - Country:US
Mailing Address - Phone:267-731-7986
Mailing Address - Fax:267-731-7977
Practice Address - Street 1:6404 ROOSEVELT BLVD.
Practice Address - Street 2:SUITE #. 1-C-2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149
Practice Address - Country:US
Practice Address - Phone:267-731-7986
Practice Address - Fax:267-731-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)