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General NPI Number Information
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NPI Number | 1386468932
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Entity Type | Individual
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Provider Name | KAITLIN FORSYTH
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 6060 PIEDMONT ROW DR S STE 140
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City | CHARLOTTE
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State | NC
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Zip | 28287-3801
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Country | US
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Telephone | 704-544-5353
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Fax |
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Provider Business Mailing Address
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Address Line | 5725 CARNEGIE BLVD APT 238
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City | CHARLOTTE
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State | NC
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Zip | 28209-4878
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Country | US
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Telephone | 803-389-5461
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12485
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP033313T
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License Number State | NC
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