Provider Demographics
NPI:1164047288
Name:FORSTER, BRIANNA QUINZI (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:QUINZI
Last Name:FORSTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:MICHELE
Other - Last Name:QUNIZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:408 HIGUERA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6135
Mailing Address - Country:US
Mailing Address - Phone:805-788-0805
Mailing Address - Fax:805-788-0845
Practice Address - Street 1:410 S MAPLE AVE STE 100
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4246
Practice Address - Country:US
Practice Address - Phone:703-988-6010
Practice Address - Fax:703-526-0430
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT210002385225100000X
VA2305213667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist