FORM PHYSICAL THERAPY, A PROFESSIONAL CORPORATION
Physical Therapy at Pine St, San Francisco, CA

License number
California 29589
Category
Ambulatory Health
Type
Physical Therapy
Owner
Name: MRS. STACEE LEE BROWN PT, DPT, ATC
Title: OWNER/PRESIDENT
Phone: (415) 297-4113
Address
Address 2
2358 Pine St, San Francisco, CA 94115
68 Dominican Dr, San Rafael, CA 94901
National Provider ID: 1174770630
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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FORM PHYSICAL THERAPY, A PROFESSIONAL CORPORATION

San Rafael, CA  -  San Francisco, CA

Industry:
Health Practitioner's Office
Registration:
May 22, 2008
Addresses:
68 Dominican Dr, San Rafael, CA 94901 (Physical)
2358 Pne St, San Francisco, CA 94115
State ID:
C3103959
Business type:
Articles of Incorporation
President:
Stacee Lee Brown (President)

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