Provider Demographics
NPI:1780465179
Name:NEXT LEVEL PHYSICAL THERAPY AND WELLNESS CORPORATION
Entity type:Organization
Organization Name:NEXT LEVEL PHYSICAL THERAPY AND WELLNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOBAT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEFTAH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:405-673-6673
Mailing Address - Street 1:10960 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10960 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6202
Practice Address - Country:US
Practice Address - Phone:405-673-6673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty