Healthcare Provider Details

I. General information

NPI: 1912828856
Provider Name (Legal Business Name): FORGE RESTORATIVE HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N AIRPORT RD
JASPER AL
35504-7533
US

IV. Provider business mailing address

405 N AIRPORT RD
JASPER AL
35504-7533
US

V. Phone/Fax

Practice location:
  • Phone: 205-221-3196
  • Fax:
Mailing address:
  • Phone: 205-221-3196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RYAN GLENN MCMORRIES
Title or Position: MEDICAL DIRECTOR, OWNER
Credential: MD
Phone: 936-371-9441