| Fly Wheel Center Ut Llc | |
|
3564 Ridgeline Dr #14a Park City UT 84098 | |
| (347) 524-8681 | |
| Not Available |
| Full Name | Fly Wheel Center Ut Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3564 Ridgeline Dr, Park City, Utah |
| Authorized Official Name and Position | Shraga F Waxman (CEO) |
| Authorized Official Contact | 3476616533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fly Wheel Center Ut Llc 174 White St Lakewood NJ 08701-4054 Ph: (347) 661-6533 | Fly Wheel Center Ut Llc 3564 Ridgeline Dr #14a Park City UT 84098 Ph: (347) 524-8681 |
| NPI Number | 1356155998 |
|---|---|
| Provider Enumeration Date | 02/04/2025 |
| Last Update Date | 02/04/2025 |
| Certification Date | 01/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356155998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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