Healthcare Provider Details

I. General information

NPI: 1891973020
Provider Name (Legal Business Name): BEYOND HEALTHCARE S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3412 NAMEOKI RD
GRANITE CITY IL
62040-3702
US

IV. Provider business mailing address

3412 NAMEOKI RD
GRANITE CITY IL
62040-3702
US

V. Phone/Fax

Practice location:
  • Phone: 618-876-7800
  • Fax: 618-876-7850
Mailing address:
  • Phone: 618-876-7800
  • Fax: 618-876-7850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON L. STROTHEIDE
Title or Position: PRESIDENT
Credential: DC
Phone: 618-876-7800