Provider Demographics
NPI:1356233944
Name:POWERSTRIDE PHYSICAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:POWERSTRIDE PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRTLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, GCS
Authorized Official - Phone:443-477-4967
Mailing Address - Street 1:16635 MYRTLE SAND DR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-4070
Mailing Address - Country:US
Mailing Address - Phone:443-477-4967
Mailing Address - Fax:
Practice Address - Street 1:16635 MYRTLE SAND DR
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-4070
Practice Address - Country:US
Practice Address - Phone:443-477-4967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist