Provider Demographics
NPI:1073999264
Name:HOME PHYSICAL THERAPY PROVIDERS & WELLNESS INC.
Entity Type:Organization
Organization Name:HOME PHYSICAL THERAPY PROVIDERS & WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:SHEEHY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:760-201-5359
Mailing Address - Street 1:1611A S MELROSE DR # 311
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-5471
Mailing Address - Country:US
Mailing Address - Phone:760-536-2377
Mailing Address - Fax:888-415-0603
Practice Address - Street 1:403 W 5TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4872
Practice Address - Country:US
Practice Address - Phone:760-536-2377
Practice Address - Fax:888-415-0603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty