Provider Demographics
NPI:1639934755
Name:PREVENT PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:PREVENT PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PREVENT PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-495-3713
Mailing Address - Street 1:4769 HOEN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7862
Mailing Address - Country:US
Mailing Address - Phone:707-495-3713
Mailing Address - Fax:
Practice Address - Street 1:4769 HOEN AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7862
Practice Address - Country:US
Practice Address - Phone:707-495-3713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty