Left of Bang LCC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

LEFT OF BANG LCC

Practice address

1201 E Cooley St Ste D
Show Low, AZ 85901-5145

Phone

(928) 826-3833

NPI assigned

Dec 28, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brock M Bevell

Title

Director

Phone

(928) 826-3833

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545955200000",
    "number": "1730651969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 E COOLEY ST STE D",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859015145",
            "telephone_number": "928-826-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E COOLEY ST STE D",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859015145",
            "telephone_number": "928-826-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEFT OF BANG LCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A",
        "authorized_official_last_name": "BEVELL",
        "authorized_official_first_name": "BROCK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-826-3833",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Wade Larson, D.C.
• Susan Elaine Lasala-Wood, DNP FNP-C, RNFA
• Eddie Duane Lauritsen
• Richard Lauritzen, LPC
• Jean M. Lee, D.MIN.
• Leon a Driss PC
• Elizabeth Letner, RN
• Jeffrey A Levison, M.D.
• Joshua Orr Lewis, O.D.
• Heath Arnold Lindsey, PA-C

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.