Provider Demographics
NPI:1033728381
Name:STRIDE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:STRIDE PHYSICAL THERAPY
Other - Org Name:STRIDE PHYSICAL THERAPY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKUBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-292-1330
Mailing Address - Street 1:706 RAIKES RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-3418
Mailing Address - Country:US
Mailing Address - Phone:215-292-1330
Mailing Address - Fax:
Practice Address - Street 1:706 RAIKES RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-3418
Practice Address - Country:US
Practice Address - Phone:215-292-1330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty