Provider Demographics
NPI:1629835780
Name:ONWARD PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ONWARD PHYSICAL THERAPY LLC
Other - Org Name:ONWARD PERFORMANCE & PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARGRAVE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, ATC, CSCS
Authorized Official - Phone:660-646-9043
Mailing Address - Street 1:1207 NW PAMELA BLVD
Mailing Address - Street 2:
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029-7844
Mailing Address - Country:US
Mailing Address - Phone:660-646-9043
Mailing Address - Fax:
Practice Address - Street 1:1207 NW PAMELA BLVD
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-7844
Practice Address - Country:US
Practice Address - Phone:660-646-9043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty