Provider Demographics
NPI:1568936987
Name:INSPIRE PHYSICAL THERAPY AND WELLNESS PC
Entity Type:Organization
Organization Name:INSPIRE PHYSICAL THERAPY AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIRSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, NCS
Authorized Official - Phone:917-837-1326
Mailing Address - Street 1:703 PIER AVE
Mailing Address - Street 2:SUITE B #425
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-3943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:226 10TH ST APT D
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-3742
Practice Address - Country:US
Practice Address - Phone:917-837-1326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251E00000XAgenciesHome Health