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General NPI Number Information
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NPI Number | 1023813714
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Entity Type | Individual
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Provider Name | KYLIE KATHLEEN FORBES
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Gender | Female
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 7533 CENTER ST
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City | MENTOR
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State | OH
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Zip | 44060-6001
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Country | US
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Telephone | 440-205-1714
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 CHEROKEE TRL
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City | WILLOUGHBY
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State | OH
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Zip | 44094-7212
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Country | US
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Telephone | 216-536-9809
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA015319
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License Number State | OH
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