Healthcare Provider Details

I. General information

NPI: 1275936999
Provider Name (Legal Business Name): JOYFUL STRIDES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 E RILEY THOMPSON RD
MUSKEGON MI
49445-9540
US

IV. Provider business mailing address

2923 OAK LN
MUSKEGON MI
49444-2523
US

V. Phone/Fax

Practice location:
  • Phone: 270-559-7107
  • Fax:
Mailing address:
  • Phone: 270-559-7107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number2007016126
License Number StateMO

VIII. Authorized Official

Name: RACHEL L JACKSON
Title or Position: PROVIDER/OWNER
Credential: OTR
Phone: 270-559-7107