Provider Demographics
NPI:1316756406
Name:HEALDSBURG PHYSICAL THERAPY AND WELLNESS PC
Entity type:Organization
Organization Name:HEALDSBURG PHYSICAL THERAPY AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARCELON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:707-433-5219
Mailing Address - Street 1:465 MARCH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3371
Mailing Address - Country:US
Mailing Address - Phone:707-433-5219
Mailing Address - Fax:707-433-5248
Practice Address - Street 1:465 MARCH AVE STE B
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3371
Practice Address - Country:US
Practice Address - Phone:707-433-5219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty