Form Physical Therapy, LLC in Saint Clair Shores, MI
This location of Form Physical Therapy bills under NPI 1750844619, an organization record issued on Apr 8, 2019 with the primary taxonomy Physical Therapy Clinic/Center. It is one of 5 NPIs registered under this name; each clinician who sees you there has their own NPI and license.
Organization recordNPPES, Aug 2026
1750844619
- Legal name
- Form Physical Therapy, LLC
- Entity
- Type 2 · organization
- Primary taxonomy
- Physical Therapy Clinic/Center 261QP2000X
- Practice location
- 22340 HARPER AVE, Saint Clair Shores, MI 48080
- Phone
- 586-330-0499
- Enumerated
- Apr 8, 2019
- Record updated
- Apr 8, 2019
- Authorized official
- Physical Therapist (title as filed)
4 clinicians CMS lists with Form Physical Therapy in Saint Clair Shores
- Jean Alway, PTPhysical Therapist1598266405
- Kelly BangstedPhysical Therapist1295939668
- Kelly Delind, PTPhysical Therapist1669974259
- Theresa Fetter, MPTPhysical Therapist1831690429
Source: CMS Doctors and Clinicians group affiliations, matched by practice name and city.
All 5 Form Physical Therapy NPIs
Every location registered under this name, in 5 cities.
See every locationChecking an organization
- Confirm the business with the Michigan secretary of state.
- Check the HHS-OIG exclusion list for the organization.
- Verify each clinician on their own record and the state license search.
Common questions
Is an organization NPI a license?
No. An NPI identifies who bills. Facilities and the clinicians who work there are licensed separately by the state.
Source: CMS National Plan and Provider Enumeration System (NPPES), monthly file of Aug 9, 2026 (NPPES files on CMS.gov). An NPI identifies who bills; it is not a license.