Provider Demographics
NPI:1245884139
Name:TODAY AND BEYOND PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:TODAY AND BEYOND PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:CRYSTAL
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:808-341-3595
Mailing Address - Street 1:2991 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-2185
Mailing Address - Country:US
Mailing Address - Phone:808-341-3595
Mailing Address - Fax:
Practice Address - Street 1:724 S CENTRAL AVE STE 104
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7808
Practice Address - Country:US
Practice Address - Phone:808-341-3595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty