Provider Demographics
NPI:1245485309
Name:BEACON PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:BEACON PHYSICAL THERAPY LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:331 COTUIT RD
Mailing Address - Street 2:BLDG 1, UNIT 4
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2428
Mailing Address - Country:US
Mailing Address - Phone:713-297-7000
Mailing Address - Fax:713-297-7090
Practice Address - Street 1:331 COTUIT RD
Practice Address - Street 2:BLDG 1, UNIT 4
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2428
Practice Address - Country:US
Practice Address - Phone:713-297-7000
Practice Address - Fax:713-297-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty