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General NPI Number Information
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NPI Number | 1053069591
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Entity Type | Organization
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Legal Business Name | BEYOND PT SOUTH PLLC
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 10106 S SHERIDAN RD STE C
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City | TULSA
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State | OK
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Zip | 74133-6731
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Country | US
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Telephone | 918-695-1485
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Fax | 918-280-0170
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Provider Business Mailing Address
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Address Line | 10106 S SHERIDAN RD STE C
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City | TULSA
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State | OK
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Zip | 74133-6776
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Country | US
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Telephone | 918-995-2500
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Fax | 918-995-2501
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | LESLIE ERIN HOWERTON
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Credential | PT, DPT
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Telephone | 918-995-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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