Form and Fitness Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

6265 Issued in CO

Legal business name

FORM AND FITNESS PHYSICAL THERAPY

Practice address

16151 Lowell Blvd
Broomfield, CO 80023-8100

Phone

(303) 404-9494

NPI assigned

Jan 28, 2009

Last updated

Jan 28, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Forman, DPT

Title

Physical Therapist, Owner

Phone

(303) 404-9494

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1982842035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13606 XAVIER LN STE C",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800233604",
            "telephone_number": "300-340-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16151 LOWELL BLVD",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800238100",
            "telephone_number": "303-404-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM AND FITNESS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "303-404-9494",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "6265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Henry Fleischmann, DDS
• Sarah Anne Fletcher, MS, LPC
• Paul Randolph Flippen, P.A.
• Chelsea Anne Fogg
• Forefront Dermatology SC
• Form and Fitness Physical Therapy LLC
• Jessica Leigh Forman
• Ryan Forrest, M.A., N.C.C.
• Fortitude Counseling LLC
• Forward Family Therapy

• Physical Therapy Clinic/Center in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Physical Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.