Provider Demographics
NPI:1891014510
Name:FOCUS PHYSICAL THERAPY, INCORPORATED
Entity Type:Organization
Organization Name:FOCUS PHYSICAL THERAPY, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WISWALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-733-7500
Mailing Address - Street 1:177 VULCAN DR
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-1406
Mailing Address - Country:US
Mailing Address - Phone:805-733-7500
Mailing Address - Fax:805-733-7510
Practice Address - Street 1:177 VULCAN DR
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-1406
Practice Address - Country:US
Practice Address - Phone:805-733-7500
Practice Address - Fax:805-733-7510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty