MEDICARE: STRIVE PERFORMANCE AND MOBILITY

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1962255596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRIVE PERFORMANCE AND MOBILITY

Provider Business Mailing Address
First Line	:	2015 WOODCLIFF ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-6013
Country	:	US
Telephone Number	:	161-473-5271
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 ASHLEY RIVER RD UNIT G
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-4619
Country	:	US
Telephone Number	:	614-735-2712
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	KIRSTEN STAUFFER
Credential	:	DPT
Telephone Number	:	614-735-2712

Provider Enumeration Date	:	04/11/2024
Last Update Date	:	04/29/2024

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Directions to “STRIVE PERFORMANCE AND MOBILITY ” Practice Location

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