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General NPI Number Information
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NPI Number | 1417074782
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Entity Type | Organization
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Legal Business Name | FOREST INJURY AND REHAB CENTER, INC.
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 12/30/2009
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Provider Practice Location Address
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Address Line | 3420 W ILLINOIS AVE STE 100
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City | DALLAS
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State | TX
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Zip | 75211-8798
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Country | US
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Telephone | 214-339-9111
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Fax | 214-339-9118
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Provider Business Mailing Address
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Address Line | 707 N RIVERSIDE DR
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City | FORT WORTH
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State | TX
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Zip | 76111-4247
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Country | US
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Telephone | 214-339-9111
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Fax | 214-339-9118
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Authorized Official
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Title or Position | OWNER MEDICAL DIRECTOR
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Name | DR. NEDA BAHADORI
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Credential | DC
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Telephone | 817-834-7422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 8940
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License Number State | TX
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