Provider Demographics
NPI:1629535356
Name:GO BEYOND PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:GO BEYOND PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROI DENNIS
Authorized Official - Middle Name:ADELA CAYETANO
Authorized Official - Last Name:SMALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:617-803-7081
Mailing Address - Street 1:7150 E CAMELBACK RD STE 444
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1257
Mailing Address - Country:US
Mailing Address - Phone:617-803-7081
Mailing Address - Fax:800-852-1426
Practice Address - Street 1:7150 E CAMELBACK RD STE 444
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-1257
Practice Address - Country:US
Practice Address - Phone:617-803-7081
Practice Address - Fax:800-852-1426
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMALLWOOD COMPANIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty