Healthcare Provider Details

I. General information

NPI: 1275498644
Provider Name (Legal Business Name): FORWARD PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 APPLETREE LN UNIT 1
MOORHEAD MN
56560-3218
US

IV. Provider business mailing address

606 38TH AVE E
WEST FARGO ND
58078-5443
US

V. Phone/Fax

Practice location:
  • Phone: 218-639-8191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DALLAS EHRMANTRAUT
Title or Position: PARTNER
Credential: DPT
Phone: 218-639-8191