Provider Demographics
NPI:1023848744
Name:FORSSBERG PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:FORSSBERG PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:FORSSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-388-6277
Mailing Address - Street 1:1219 E 1ST ST STE H
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-2081
Mailing Address - Country:US
Mailing Address - Phone:620-419-4009
Mailing Address - Fax:
Practice Address - Street 1:1219 E 1ST ST STE H
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-2081
Practice Address - Country:US
Practice Address - Phone:620-419-4009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty