FORM PHYSICAL THERAPY
NPI 1174770630
Clinic/Center - Physical Therapy in San Francisco, CA

Active since August 26, 2008
2358 PINE STREET, SAN FRANCISCO, CA 94115(415) 297-4113(415) 684-7694 Get Directions Write a Review

NPPES record last updated: September 6, 2012. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Form Physical Therapy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORM PHYSICAL THERAPY (NPI 1174770630) is a healthcare organization registered as a physical therapy in San Francisco, California and active in the NPI registry since August 2008. The organization lists Stacee Lee Brown, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1174770630
Entity TypeOrganization
Primary Taxonomy261QP2000X
Legal Business NameFORM PHYSICAL THERAPY, A PROFESSIONAL CORPORATION
Location Address2358 PINE STREETSan Francisco, CA 94115
Mailing Address68 Dominican DriveSan Rafael, CA 94901 · (415) 297-4113 · Fax (415) 684-7694
Fax(415) 684-7694
Organization SubpartNo
Authorized OfficialStacee Lee BrownOwner/president · (415) 297-4113
Enumeration DateAugust 26, 2008
Last NPPES UpdateSeptember 6, 2012
NPI 1174770630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Physical TherapyAmbulatory Health Care Facilities
Taxonomy Code261QP2000X
License Licensed in CA · 29589
Definition
An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
2358 PINE STREET, San Francisco, CA 94115

Other Names 1

Doing Business AsForm Physical Therapy

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Form Physical Therapy, A Professional Corporation's NPI number?

The NPI number for Form Physical Therapy, A Professional Corporation is 1174770630. It was assigned to this organization in the NPPES registry on August 26, 2008. The provider is doing business as Form Physical Therapy.

Where is Form Physical Therapy, A Professional Corporation located?

Form Physical Therapy, A Professional Corporation is located at 2358 Pine Street, San Francisco, CA 94115. The listed phone number is (415) 297-4113.

What is Form Physical Therapy, A Professional Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.

When was this NPI record last updated?

The NPPES record for Form Physical Therapy, A Professional Corporation was last updated on September 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.