Provider Demographics
NPI:1023570959
Name:PURPOSE DRIVEN THERAPY LLC
Entity Type:Organization
Organization Name:PURPOSE DRIVEN THERAPY LLC
Other - Org Name:PURPOSE DRIVEN THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JUNDI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-805-4786
Mailing Address - Street 1:3012 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-3622
Mailing Address - Country:US
Mailing Address - Phone:330-805-4786
Mailing Address - Fax:330-313-3804
Practice Address - Street 1:3012 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-3622
Practice Address - Country:US
Practice Address - Phone:330-805-4786
Practice Address - Fax:866-954-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0371730Medicaid