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General NPI Number Information
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NPI Number | 1336721802
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Entity Type | Organization
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Legal Business Name | BEYOND PHYSICAL THERAPY & PERFORMANCE PLLC
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Dates
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Enumeration Date | 04/24/2021
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Last Update Date | 04/24/2021
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Provider Practice Location Address
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Address Line | 109 13TH AVE S
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City | NAMPA
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State | ID
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Zip | 83651-3904
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Country | US
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Telephone | 208-995-6671
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Fax | 208-473-7313
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Provider Business Mailing Address
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Address Line | 17415 N FLAGSTAFF WAY
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City | NAMPA
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State | ID
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Zip | 83687-5495
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Country | US
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Telephone | 208-995-6671
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Fax | 208-473-7313
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | BEAU DOBSON
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Credential | DPT
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Telephone | 608-558-3657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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