Form Physical Therapy

LBN: Form Physical Therapy, A Professional Corporation
Form Physical Therapy is an health care organization with primary practice located at 2358 Pine Street , San Francisco CA 94115. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Form Physical Therapy, A Professional Corporation can be contacted via phone (415) 297-4113, or through Brown, Stacee Lee via phone (415) 297-4113.

Contact Information

Primary practice address
2358 Pine Street San Francisco CA 94115
Phone: (415) 297-4113
Fax: (415) 684-7694
Website:
Map and Directions
Authorized official contact:
Name: Brown, Stacee Lee PT, DPT, ATC
Phone: (415) 297-4113

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X 29589 California

Profile Details

NPI number 1174770630
LBN Legal business name Form Physical Therapy, A Professional Corporation
DBA Doing business as Form Physical Therapy
Authorized official Brown, Stacee Lee PT, DPT, ATC
Entity Organization
Organization subpart 1 No
Enumeration date Aug 26th, 2008
Last updated Sep 6th, 2012 - about 12 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.

Request for update

Popular Providers