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NPI Code Detail

MEDICARE: JENNIFER FORGE PT

MEDICARE: JENNIFER FORGE PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1290821TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11290821OTHERTXTEXAS PHYSICAL THERAPY LISCENSE

General Provider Information

NPI Number : 1861904328
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER FORGE PT
Provider Business Mailing Address
First Line : 8627 CINNAMON CREEK DR STE 402
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-1482
Country : US
Telephone Number : 210-695-8731
Fax Number :
Provider Business Practice Location Address
First Line : 12952 BANDERA RD STE 107
Second Line :
City : HELOTES
State : TX
Zip : 78023-4733
Country : US
Telephone Number : 210-372-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2017
Last Update Date : 12/27/2021

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Directions to “ JENNIFER FORGE PT” Practice Location

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