Provider Demographics
NPI:1952625956
Name:STROUPE, RONALD VANCE JR (MPT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:VANCE
Last Name:STROUPE
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 N CHURCH ST
Mailing Address - Street 2:STE D
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5632
Mailing Address - Country:US
Mailing Address - Phone:336-274-7480
Mailing Address - Fax:336-274-8903
Practice Address - Street 1:2105 BRAXTON LN
Practice Address - Street 2:STE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2801
Practice Address - Country:US
Practice Address - Phone:336-458-3694
Practice Address - Fax:336-333-6306
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist