Provider Demographics
NPI:1215137294
Name:FORRY, KATHRYN ARNDT (DOTR)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ARNDT
Last Name:FORRY
Suffix:
Gender:F
Credentials:DOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4878
Mailing Address - Country:US
Mailing Address - Phone:615-293-6063
Mailing Address - Fax:
Practice Address - Street 1:1400 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4878
Practice Address - Country:US
Practice Address - Phone:615-293-6063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3780174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist