Healthcare Provider Details

I. General information

NPI: 1588275705
Provider Name (Legal Business Name): BEYOND PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 08/11/2020
Certification Date: 08/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 S EAST ST
RALEIGH NC
27601-2369
US

IV. Provider business mailing address

4411 MANOR VILLAGE WAY APT 104
RALEIGH NC
27612-3786
US

V. Phone/Fax

Practice location:
  • Phone: 716-397-7528
  • Fax:
Mailing address:
  • Phone: 716-397-7528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CAITLIN GREENSTEIN
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT, OCS
Phone: 716-397-7528