Healthcare Provider Details

I. General information

NPI: 1609937424
Provider Name (Legal Business Name): DEBORAH CLAYTON FORREST P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6531 PORT REPUBLIC RD
HARRISONBURG VA
22801-6012
US

IV. Provider business mailing address

6531 PORT REPUBLIC RD
HARRISONBURG VA
22801-6012
US

V. Phone/Fax

Practice location:
  • Phone: 540-421-3989
  • Fax: 540-289-3876
Mailing address:
  • Phone: 540-421-3989
  • Fax: 540-289-3876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305004107
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: