Healthcare Provider Details
I. General information
NPI: 1083156301
Provider Name (Legal Business Name): FORREST MEDICAL CONSULTING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2016
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
171 PLEASANT ST
CONCORD NH
03301-2547
US
IV. Provider business mailing address
171 PLEASANT ST
CONCORD NH
03301-2547
US
V. Phone/Fax
- Phone: 603-848-1540
- Fax: 603-228-3503
- Phone: 603-848-1540
- Fax: 603-228-3503
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
FORREST
Title or Position: OWNER
Credential: MD
Phone: 603-848-1540