MEDICARE: STRONG STRIDE PHYSICAL THERAPY & PERFORMANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251S0007X	Sports Physical Therapist

General Provider Information

NPI Number	:	1205700325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRONG STRIDE PHYSICAL THERAPY & PERFORMANCE

Provider Business Mailing Address
First Line	:	635 SENTINEL OAK LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-8203
Country	:	US
Telephone Number	:	716-499-5341
Fax Number	:

Provider Business Practice Location Address
First Line	:	8416 BELLHAVEN BLVD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-6103
Country	:	US
Telephone Number	:	716-499-5341
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIN KOENKE
Credential	:	PT, DPT
Telephone Number	:	716-499-5341

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/01/2025

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Directions to “STRONG STRIDE PHYSICAL THERAPY & PERFORMANCE ” Practice Location

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