Basic Information
Provider Information
NPI: 1699019935
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FORSHEY
FirstName: JAMES
MiddleName: ARON
NamePrefix:  
NameSuffix:  
Credential: LPTA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1716 GIHON RD
Address2:  
City: PARKERSBURG
State: WV
PostalCode: 261019655
CountryCode: US
TelephoneNumber: 3044855511
FaxNumber: 3044853511
Practice Location
Address1: 1716 GIHON RD
Address2:  
City: PARKERSBURG
State: WV
PostalCode: 261019655
CountryCode: US
TelephoneNumber: 3044855511
FaxNumber: 3044853511
Other Information
ProviderEnumerationDate: 11/26/2012
LastUpdateDate: 03/08/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X000965WVY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


Home