Organization
MINDFUL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOHN BORGESON MPT, MS (PRESIDENT)
(415) 256-9990
Entity
Organization
Contact information
Practice address
901 SIR FRANCIS DRAKE BLVD, SUITE B, KENTFIELD, CA 94904-1502
(415) 256-9990
(415) 256-9991
Mailing address
901 SIR FRANCIS DRAKE BLVD, SUITE B, KENTFIELD, CA 94904-1502
(415) 256-9990
(415) 256-9991
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT24068
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C3455707
CALIFORNIA CORPORATION NUMBER/S-CORP ENTITY ID
CA
Enumeration date
09/20/2012
Last updated
01/07/2013
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