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General NPI Number Information
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NPI Number | 1093337420
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Entity Type | Organization
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Legal Business Name | FORWARD SPINE & SPORT LLC
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 400 COMMONWEALTH AVE STE G1
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City | BOSTON
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State | MA
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Zip | 02215-2813
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Country | US
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Telephone | 617-580-2822
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Fax | 855-741-0559
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Provider Business Mailing Address
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Address Line | 400 COMMONWEALTH AVE STE G1
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City | BOSTON
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State | MA
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Zip | 02215-2813
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Country | US
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Telephone | 617-580-2822
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Fax | 850-741-0559
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRYAN MORAN KENT
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Credential | DC, L.AC.
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Telephone | 585-410-2081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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