Healthcare Provider Details

I. General information

NPI: 1669053526
Provider Name (Legal Business Name): STRIVE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 N 167TH ST
OMAHA NE
68116-2962
US

IV. Provider business mailing address

4530 N 167TH ST
OMAHA NE
68116-2962
US

V. Phone/Fax

Practice location:
  • Phone: 402-990-0143
  • Fax:
Mailing address:
  • Phone: 402-990-0143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DILLON D EUREK
Title or Position: CEO
Credential:
Phone: 402-990-0143