Basic Information
| Provider Information | |||||||||
| NPI: | 1659962587 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STRIVE PHYSICAL THERAPY SPECIALISTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 LYNDON FARM CT STE 300 | ||||||||
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| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402235005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566774000 | ||||||||
| FaxNumber: | 8562343014 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 JOHN F KENNEDY BLVD STE 450 | ||||||||
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| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191021733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154542812 | ||||||||
| FaxNumber: | 2672395027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2021 | ||||||||
| LastUpdateDate: | 10/13/2022 | ||||||||
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| AuthorizedOfficialLastName: | HERKLOZ | ||||||||
| AuthorizedOfficialFirstName: | ERICH | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8566774000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | N | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.