Provider Demographics
NPI:1235965427
Name:NEXT LEVEL SPORTS PERFORMANCE & THERAPY LLC
Entity type:Organization
Organization Name:NEXT LEVEL SPORTS PERFORMANCE & THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:COLTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, SCS, CSCS
Authorized Official - Phone:572-275-0023
Mailing Address - Street 1:3133 WELLING RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-9404
Mailing Address - Country:US
Mailing Address - Phone:572-275-0023
Mailing Address - Fax:
Practice Address - Street 1:820 IRISH LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5878
Practice Address - Country:US
Practice Address - Phone:572-275-0023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy