Backtogolf Performance & Fitness Inc

LBN: Backtogolf Performance & Fitness Inc
Backtogolf Performance & Fitness Inc is an health care organization with primary practice located at 208 Concourse Blvd , Santa Rosa CA 95403. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty. Backtogolf Performance & Fitness Inc can be contacted via phone (707) 303-4992, or through Mullnix, Mary K via phone (707) 303-4995.

Contact Information

Primary practice address
208 Concourse Blvd Santa Rosa CA 95403
Phone: (707) 303-4992
Fax: (707) 303-4996
Website:
Map and Directions
Authorized official contact:
Name: Mullnix, Mary K
Phone: (707) 303-4995

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT11380 California

Profile Details

NPI number 1669571188
LBN Legal business name Backtogolf Performance & Fitness Inc
DBA Doing business as
Authorized official Mullnix, Mary K
Entity Organization
Organization subpart 1 No
Enumeration date Sep 21st, 2006
Last updated Apr 14th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669571188 NPPES
Other DB6552 RAILROAD MEDICARE GRP #
Other ZZZ00793Z RAILROAD MEDICARE GRP #
Other P00120133 RAILROAD MEDICARE GRP #
Other 105079200 RAILROAD MEDICARE GRP #

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