Provider Demographics
NPI:1508015462
Name:NEXT LEVEL PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:NEXT LEVEL PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-345-6578
Mailing Address - Street 1:PO BOX 25322
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85285-5322
Mailing Address - Country:US
Mailing Address - Phone:480-345-6578
Mailing Address - Fax:480-345-4081
Practice Address - Street 1:4820 S ASH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6733
Practice Address - Country:US
Practice Address - Phone:480-345-6578
Practice Address - Fax:480-345-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy