Provider Demographics
NPI:1609061712
Name:INNER STRENGTH PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:INNER STRENGTH PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:ADELE
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:910-799-7009
Mailing Address - Street 1:5725 OLEANDER DR
Mailing Address - Street 2:SUITE B-6
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4745
Mailing Address - Country:US
Mailing Address - Phone:910-799-7009
Mailing Address - Fax:910-799-7059
Practice Address - Street 1:5725 OLEANDER DR
Practice Address - Street 2:SUITE B-6
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4745
Practice Address - Country:US
Practice Address - Phone:910-799-7009
Practice Address - Fax:910-799-7059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10789261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DH1166OtherRETIRED RAILROAD MEDICARE