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General NPI Number Information
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NPI Number | 1124011812
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Entity Type | Organization
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Legal Business Name | ABOVE & BEYOND THERAPY SERVICES LLC
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 3233 W PEORIA AVE SUITE 224
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City | PHOENIX
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State | AZ
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Zip | 85029-4614
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Country | US
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Telephone | 602-866-2231
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Fax | 602-866-2261
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Provider Business Mailing Address
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Address Line | 3233 W PEORIA AVE SUITE 224
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City | PHOENIX
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State | AZ
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Zip | 85029-4614
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Country | US
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Telephone | 602-866-2231
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Fax | 602-866-2261
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Authorized Official
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Title or Position | OWNER/PT
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Name | MR. THOMAS J LONG
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Credential | PT
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Telephone | 602-866-2231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | AZ
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Taxonomy #2
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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 | AZ
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Taxonomy #3
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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 | AZ
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