Provider Demographics
NPI:1447573118
Name:TOM LONG LLC
Entity Type:Organization
Organization Name:TOM LONG LLC
Other - Org Name:ABOVE & BEYOND THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ P.T.
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:602-866-2231
Mailing Address - Street 1:3233 W PEORIA AVE
Mailing Address - Street 2:SUITE 224
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4614
Mailing Address - Country:US
Mailing Address - Phone:602-866-2231
Mailing Address - Fax:602-866-2261
Practice Address - Street 1:3233 W PEORIA AVE
Practice Address - Street 2:SUITE 224
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4614
Practice Address - Country:US
Practice Address - Phone:602-866-2231
Practice Address - Fax:602-866-2261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty