Provider Demographics
NPI:1467074955
Name:STRONG AGAIN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:STRONG AGAIN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-206-6240
Mailing Address - Street 1:1083 PRAIRIE ZINNIA DR
Mailing Address - Street 2:
Mailing Address - City:BERNALILLO
Mailing Address - State:NM
Mailing Address - Zip Code:87004-5801
Mailing Address - Country:US
Mailing Address - Phone:505-933-7994
Mailing Address - Fax:505-930-7136
Practice Address - Street 1:1083 PRAIRIE ZINNIA DR
Practice Address - Street 2:
Practice Address - City:BERNALILLO
Practice Address - State:NM
Practice Address - Zip Code:87004-5801
Practice Address - Country:US
Practice Address - Phone:505-933-7994
Practice Address - Fax:505-930-7136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty