Form & Fitness

LBN: Form & Fitness
Form & Fitness is an health care organization with primary practice located at 11053 N Port Washington Rd , Mequon WI 53092-5032. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty. Form & Fitness can be contacted via phone (262) 241-3449, or through Quist, Ben via phone (262) 241-3449.

Contact Information

Primary practice address
11053 N Port Washington Rd Mequon WI 53092-5032
Phone: (262) 241-3449
Fax: (262) 241-5229
Website:
Map and Directions
Authorized official contact:
Name: Quist, Ben DPT
Phone: (262) 241-3449

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X

Profile Details

NPI number 1063612067
LBN Legal business name Form & Fitness
DBA Doing business as
Authorized official Quist, Ben DPT
Entity Organization
Organization subpart 1 No
Enumeration date Jul 19th, 2007
Last updated Jul 19th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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