Form & Fitness - Physical Therapist in Mequon, WI

Form & Fitness is a Physical Therapist based in Mequon, Wisconsin. Form & Fitness is licensed to practice in * (Not Available) (license number ) and their current practice location is 11053 N Port Washington Rd, Mequon, Wisconsin. It can be reached at their office (for appointments etc.) via phone at (262) 241-3449.

NPI number for Form & Fitness is 1063612067 and their current mailing address is 11053 N Port Washington Rd, Mequon, Wisconsin. Form & Fitness does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1063612067.

Contact Information

Form & Fitness
11053 N Port Washington Rd,
Mequon, WI 53092-5032
(262) 241-3449
(262) 241-5229



Healthcare Provider's Profile

Full NameForm & Fitness
TypeFacility
SpecialityPhysical Therapist
Location11053 N Port Washington Rd, Mequon, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1063612067
  • Provider Enumeration Date: 07/19/2007
  • Last Update Date: 07/19/2007

Medical Identifiers

Medical identifiers for Form & Fitness such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063612067NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Form & Fitness is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Form & Fitness
11053 N Port Washington Rd,
Mequon, WI 53092-5032

Ph: (262) 241-3449
Form & Fitness
11053 N Port Washington Rd,
Mequon, WI 53092-5032

Ph: (262) 241-3449

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› Verified 4 days ago


Physical Therapist in Mequon, WI

April Belk, PT, DPT
Physical Therapist
Medicare: Medicare Enrolled
Practice Location: 11430 N Port Washington Rd, Mequon, WI 53092
Phone: 262-518-1900    
Lois Harrison,
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 12800 N Lake Shore Dr, Mequon, WI 53097
Phone: 262-243-4468    
Jennifer D'urso, PT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1249 W Liebau Rd, Mequon, WI 53092
Phone: 262-243-4161    Fax: 262-243-4166
Mrs. Sandra Pacl, P.T.
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 12600 N Port Washington Rd, Mequon, WI 53092
Phone: 262-387-8818    
Monika Maria De Arteaga, PT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 11649 N Port Washington Rd, Mequon, WI 53092
Phone: 262-241-8022    
Dr. Melanie Thierfelder, DPT
Physical Therapist
Medicare: Medicare Enrolled
Practice Location: 11363 N Port Washington Rd, Mequon, WI 53092
Phone: 262-833-2060    Fax: 262-833-2061

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