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FORM MEDICAL PLLC NPI 1831616390


NPI Information

NPI: 1831616390
Provider Name: FORM MEDICAL, PLLC

Doing Business As: FORM MEDICAL

Classification: Physical Medicine & Rehabilitation - 2081N0008X
Entity Type: Organization

Specialization: Neuromuscular Medicine

Address:
1525 RALEIGH ST STE 220
DENVER, CO
ZIP 80204
Phone: (720) 370-9559
Get Directions

FORM MEDICAL, PLLC is a neuromuscular medicine physical medicine rehabilitation in Denver, CO. The provider is a physician who specializes in neuromuscular medicine possesses specialized knowledge in the science, clinical evaluation and management of these disorders. This encompasses the knowledge of the pathology, diagnosis and treatment of these disorders at a level that is significantly beyond the training and knowledge expected of a general neurologist, child neurologist or physiatrist. FORM MEDICAL, PLLC NPI is 1831616390. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Form Medical.

The provider's business location address is:

1525 RALEIGH ST STE 220
DENVER, CO
ZIP 80204-374
Phone: (720) 370-9559

The provider's authorized official is Jessica Kelner .
The authorized official title is Physician/manager and has the following contact phone number (720) 370-9559.

The enumeration date for this NPI number is 8/25/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12081N0008XPhysical Medicine & RehabilitationNeuromuscular MedicineDR.0058123COLORADOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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