Instride Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT017599 Issued in PA

Legal business name

INSTRIDE PHYSICAL THERAPY LLC

Practice address

1402 Industrial Highway
Unit B
Eddystone, PA 19022-1522

Phone

(484) 472-6950

Fax

(484) 472-6948

NPI assigned

Nov 21, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Joseph John Ricci, MPT

Title

Ceo

Phone

(484) 472-6950

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1780928267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 INDUSTRIAL HIGHWAY",
            "address_2": "UNIT B",
            "city": "EDDYSTONE",
            "state": "PA",
            "postal_code": "190221522",
            "telephone_number": "484-472-6950",
            "fax_number": "484-472-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 INDUSTRIAL HIGHWAY",
            "address_2": "UNIT B",
            "city": "EDDYSTONE",
            "state": "PA",
            "postal_code": "190221522",
            "telephone_number": "484-472-6950",
            "fax_number": "484-472-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTRIDE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-21",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "RICCI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-472-6950",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT017599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chimene N Fachehoun
• Dorothy Fessler, RN
• Latifah Griffin
• Grossinger Neuropain Specialists PC
• Bruce H. Grossinger, DO
• Igdaliah Jackson, PHARM D
• Patrice Sheree Johnson, REGISTERED NURSE
• Doreen Jones
• Nichole Suzanne Kelso, LCSW
• Joseph Francis Kerrigan Jr.

• All providers in Eddystone, PA
• Physical Therapy Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.