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NPI 1669141180

NPI 1669141180 : JAMIE FORREST PT : ABERDEEN, SD

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General NPI Number Information
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    NPI Number           |    1669141180
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    Entity Type          |    Individual 
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    Provider Name        |    JAMIE FORREST PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/08/2021
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    Last Update Date     |    09/08/2021
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Provider Practice Location Address
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    Address Line         |    125 RAILROAD AVE SE 
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    City                 |    ABERDEEN
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    State                |    SD
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    Zip                  |    57401-4202
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    Country              |    US
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    Telephone            |    606-053-8026
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    601 N CONGRESS ST 
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    City                 |    ABERDEEN
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    State                |    SD
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    Zip                  |    57401-3017
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    Country              |    US
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    Telephone            |    605-380-2652
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    Fax                  |    605-250-0999
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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        |    2251G0304X
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    Taxonomy Name        |    Geriatric Physical Therapist
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    License Number       |    1323
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    License Number State |    SD
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