Provider Demographics
NPI:1912752940
Name:FLEX FACTOR PHYSICAL THERAPY
Entity type:Organization
Organization Name:FLEX FACTOR PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SRAVAN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:NAGABANDI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:503-970-5381
Mailing Address - Street 1:24308 BASHIAN DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2922
Mailing Address - Country:US
Mailing Address - Phone:503-970-5381
Mailing Address - Fax:
Practice Address - Street 1:43000 W 9 MILE RD STE 117
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-4180
Practice Address - Country:US
Practice Address - Phone:503-970-5381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy