| Organization Name: | KID STRIDES THERAPY, LLC |
| NPI Number: | 1609115062 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMANDA BETH PENNINGTON (PHYSICAL THERAPIST) |
| Mailing Address: | 2485 Spero Rd Randleman |
| State: | NC US |
| Postal Code: | 273177626 |
| Phone Number: | 3366727111 |
| Fax Number: | |
| NPI Enumeration Date: | 02/05/2013 |
| NPI Last Update Date: | 02/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 9828 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |