Provider Demographics
NPI:1184302051
Name:NIKE THERAPY SERVICES LLC
Entity type:Organization
Organization Name:NIKE THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HAND THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-496-8262
Mailing Address - Street 1:1075 REED ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-3810
Mailing Address - Country:US
Mailing Address - Phone:314-496-8262
Mailing Address - Fax:
Practice Address - Street 1:1021 S WOLFE ROAD
Practice Address - Street 2:#125 CLEARWATER OFFICE BUILDING
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-8878
Practice Address - Country:US
Practice Address - Phone:408-888-6104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty