Healthcare Provider Details

I. General information

NPI: 1023570959
Provider Name (Legal Business Name): PURPOSE DRIVEN THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 GRAHAM RD
STOW OH
44224-3622
US

IV. Provider business mailing address

3012 GRAHAM RD
STOW OH
44224-3622
US

V. Phone/Fax

Practice location:
  • Phone: 330-805-4786
  • Fax: 866-954-0507
Mailing address:
  • Phone: 330-805-4786
  • Fax: 330-313-3804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LISA MARIE JUNDI
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT
Phone: 330-805-4786