Provider Demographics
NPI:1326549965
Name:PHYSIOFIT PHYSICAL THERAPY & WELLNESS, P.C.
Entity Type:Organization
Organization Name:PHYSIOFIT PHYSICAL THERAPY & WELLNESS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMITA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-947-8500
Mailing Address - Street 1:1000 FREMONT AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6054
Mailing Address - Country:US
Mailing Address - Phone:650-947-8500
Mailing Address - Fax:650-947-8501
Practice Address - Street 1:1000 FREMONT AVE STE 108
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6054
Practice Address - Country:US
Practice Address - Phone:650-947-8500
Practice Address - Fax:650-947-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty