Healthcare Provider Details

I. General information

NPI: 1497237630
Provider Name (Legal Business Name): FLEX PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 09/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N BRAND BLVD STE 600
GLENDALE CA
91203-2349
US

IV. Provider business mailing address

450 N BRAND BLVD STE 600
GLENDALE CA
91203-2349
US

V. Phone/Fax

Practice location:
  • Phone: 747-477-3464
  • Fax: 747-477-3463
Mailing address:
  • Phone: 747-477-3464
  • Fax: 747-477-3463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHUSHAN YEGHIKYAN
Title or Position: CEO
Credential:
Phone: 747-477-3464