Provider Demographics
NPI:1932353034
Name:FOCUS FORWARD WELLNESS & PHYSICAL THERAPY
Entity Type:Organization
Organization Name:FOCUS FORWARD WELLNESS & PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BIALE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:707-942-3927
Mailing Address - Street 1:2436 FOOTHILL BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CALISTOGA
Mailing Address - State:CA
Mailing Address - Zip Code:94515-1209
Mailing Address - Country:US
Mailing Address - Phone:707-942-3927
Mailing Address - Fax:707-942-3965
Practice Address - Street 1:2436 FOOTHILL BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1209
Practice Address - Country:US
Practice Address - Phone:707-942-3927
Practice Address - Fax:707-942-3965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 19438261QP2000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy