Form and Function Physical Therapy Pllc

Form and Function Physical Therapy Pllc is a healthcare organization registered as Physical Therapy Clinic/Center in Glen Allen, VA, holding Type 2 (organization) NPI 1578265476 since 2023. The authorized official on file is Pratik Shah, Ceo.

✓ Active NPI ✓ Valid NPI checksum

NPI	1578265476
Entity type	Organization (Type 2)
Legal business name	Form and Function Physical Therapy Pllc
Practice address	11411 HUNTON COTTAGE CT, Glen Allen, VA, 23059
Phone	8045645194
Enumeration date	2023-03-22
Last updated in NPPES	2023-03-28

Authorized official

Name	Pratik Shah
Title	Ceo
Phone	8045645194

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261QP2000X	Physical Therapy Clinic/Center	Primary	—	—

Copy-ready billing details

Provider: Form and Function Physical Therapy Pllc
NPI: 1578265476
Taxonomy: 261QP2000X (Physical Therapy Clinic/Center)
Address: 11411 HUNTON COTTAGE CT, Glen Allen, VA, 23059

Verify this record

Cross-check NPI 1578265476 against the authoritative CMS record: view Form and Function Physical Therapy Pllc on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Form and Function Physical Therapy Pllc located?

The practice location on file with NPPES is in Glen Allen, VA.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-03-28. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-03-28.