Provider Demographics
NPI:1023603487
Name:STRIDE WELLNESS LLC
Entity type:Organization
Organization Name:STRIDE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:UDING
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:773-458-5615
Mailing Address - Street 1:383 W FOUNTAIN ST STE 121
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-3515
Mailing Address - Country:US
Mailing Address - Phone:401-227-0094
Mailing Address - Fax:
Practice Address - Street 1:383 W FOUNTAIN ST STE 121
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-3515
Practice Address - Country:US
Practice Address - Phone:401-227-0094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-07
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy