Healthcare Provider Details

I. General information

NPI: 1386592053
Provider Name (Legal Business Name): STRYDE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 MICHIGAN ST NE STE 104
GRAND RAPIDS MI
49506-1215
US

IV. Provider business mailing address

650 OTTILLIA ST SE
GRAND RAPIDS MI
49507-3240
US

V. Phone/Fax

Practice location:
  • Phone: 616-610-2113
  • Fax:
Mailing address:
  • Phone: 616-610-2113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: THOMAS ALEXANDER BOSCH
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: DPT
Phone: 616-610-2113