Healthcare Provider Details

I. General information

NPI: 1699601385
Provider Name (Legal Business Name): BRIANNA ELIZABETH CARLENA FORBES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 PASEO DEL PUEBLO SUR
TAOS NM
87571-6758
US

IV. Provider business mailing address

294 W 1150 N
LAYTON UT
84041-2117
US

V. Phone/Fax

Practice location:
  • Phone: 575-613-1240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14293406-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: