Provider Demographics
NPI:1023770633
Name:BODYFUL PHYSICAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:BODYFUL PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:510-788-1299
Mailing Address - Street 1:2929 SUMMIT ST STE 208
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3423
Mailing Address - Country:US
Mailing Address - Phone:510-788-1299
Mailing Address - Fax:510-217-3574
Practice Address - Street 1:2929 SUMMIT ST STE 208
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3423
Practice Address - Country:US
Practice Address - Phone:510-788-1299
Practice Address - Fax:510-217-3574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy