Healthcare Provider Details

I. General information

NPI: 1689085078
Provider Name (Legal Business Name): KATHRYN FORSYTH MS, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 10/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF DENVER 2201 E. ASBURY AVE, RM 1312
DENVER CO
80208-0001
US

IV. Provider business mailing address

1235 GRANT ST APT 614
DENVER CO
80203-2325
US

V. Phone/Fax

Practice location:
  • Phone: 303-871-2225
  • Fax: 303-871-3666
Mailing address:
  • Phone: 517-712-0857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number0000814
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: