Organization Name: | FORM & FITNESS |
NPI Number: | 1063612067 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BEN QUIST (PRESIDENT) |
Mailing Address: | 11053 N Port Washington Rd Mequon |
State: | WI US |
Postal Code: | 530925032 |
Phone Number: | 2622413449 |
Fax Number: | 2622415229 |
NPI Enumeration Date: | 07/19/2007 |
NPI Last Update Date: | 07/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |