Provider Demographics
NPI:1053069591
Name:BEYOND PT SOUTH PLLC
Entity Type:Organization
Organization Name:BEYOND PT SOUTH PLLC
Other - Org Name:BEYOND PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:HOWERTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:918-995-2500
Mailing Address - Street 1:10106 S SHERIDAN RD STE C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6776
Mailing Address - Country:US
Mailing Address - Phone:918-995-2500
Mailing Address - Fax:918-995-2501
Practice Address - Street 1:10106 S SHERIDAN RD STE C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6731
Practice Address - Country:US
Practice Address - Phone:918-695-1485
Practice Address - Fax:918-280-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty