Provider Demographics
NPI:1093313074
Name:BYOND PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:BYOND PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:262-204-7672
Mailing Address - Street 1:11320 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-1401
Mailing Address - Country:US
Mailing Address - Phone:262-204-7672
Mailing Address - Fax:
Practice Address - Street 1:11320 W FOREST HOME AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-1401
Practice Address - Country:US
Practice Address - Phone:262-204-7672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1467702019OtherNPI
WI1811412786OtherNPI