Age With Strength Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

AGE WITH STRENGTH PHYSICAL THERAPY LLC

Practice address

2276 Birchard Ave
Fremont, OH 43420-2605

Phone

(814) 602-9660

NPI assigned

Apr 25, 2022

Organization subpart

No

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

Authorized official

Name

Mark Tattersall, DPT

Title

Owner/Physical Therapist

Phone

(814) 602-9660

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1992449052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2276 BIRCHARD AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2276 BIRCHARD AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202605",
            "telephone_number": "814-602-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE WITH STRENGTH PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "TATTERSALL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "814-602-9660",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.