Organization
FLY WHEEL CENTER UT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHRAGA F WAXMAN (CEO)
(347) 661-6533
Entity
Organization
Contact information
Practice address
3564 RIDGELINE DR, #14A, PARK CITY, UT 84098
(347) 524-8681
Mailing address
174 WHITE ST, LAKEWOOD, NJ 08701-4054
(347) 661-6533
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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