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General NPI Number Information
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NPI Number | 1366098287
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Entity Type | Organization
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Legal Business Name | JOINT NAPA VALLEY PHYSICAL THERAPY, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 04/04/2020
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Provider Practice Location Address
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Address Line | 1282 VIDOVICH AVE STE D
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City | SAINT HELENA
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State | CA
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Zip | 94574-2052
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Country | US
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Telephone | 707-287-4437
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Fax |
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Provider Business Mailing Address
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Address Line | 1282 VIDOVICH AVE STE D
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City | SAINT HELENA
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State | CA
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Zip | 94574-2052
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Country | US
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Telephone | 707-287-4437
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAUL J. WIESNER
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Credential | PT, DPT
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Telephone | 707-287-4437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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