Provider Demographics
NPI:1043989460
Name:BEYOND PHYSICAL THERAPY AT BERRY FARMS
Entity Type:Organization
Organization Name:BEYOND PHYSICAL THERAPY AT BERRY FARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:PERE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:318-332-7585
Mailing Address - Street 1:2195 LOUDENSLAGER DR
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-5313
Mailing Address - Country:US
Mailing Address - Phone:318-332-7585
Mailing Address - Fax:
Practice Address - Street 1:3100 VILLAGE PLAINS BLVD.
Practice Address - Street 2:SUITE 160
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064
Practice Address - Country:US
Practice Address - Phone:629-239-2691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty