Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Backtogolf Performance & Fitness Inc

Organization Physical Therapist · NPI 1669571188

Backtogolf Performance & Fitness Inc is a Physical Therapist in Santa Rosa, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

208 Concourse Blvd
Santa Rosa, CA 95403
Phone: (707) 303-4992
Fax: (707) 303-4996
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT11380 (CA)

Record details

NPI number1669571188
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Mullnix — Practice Administrator · (707) 303-4995
NPI enumeratedSeptember 21, 2006
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020
Mailing addressPo Box 10, Suite 2, Windsor, CA 95492

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