Provider Demographics
NPI:1144838780
Name:INSPIRED PHYSICAL THERAPY
Entity type:Organization
Organization Name:INSPIRED PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISANE
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:AUTH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, CFMM, ATC
Authorized Official - Phone:757-777-4565
Mailing Address - Street 1:870 N MILITARY HWY
Mailing Address - Street 2:SUITE 224
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3638
Mailing Address - Country:US
Mailing Address - Phone:757-777-4565
Mailing Address - Fax:
Practice Address - Street 1:870 N MILITARY HWY, SUITE 224
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3638
Practice Address - Country:US
Practice Address - Phone:757-777-4565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy