Provider Demographics
NPI:1306107693
Name:FORET, NATALIE BRYAN (DPT)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:BRYAN
Last Name:FORET
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:ELISE
Other - Last Name:BRYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1284 PARAMORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454
Mailing Address - Country:US
Mailing Address - Phone:757-650-6814
Mailing Address - Fax:757-271-5515
Practice Address - Street 1:240 MUSTANG TRAIL
Practice Address - Street 2:SUITE 8
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452
Practice Address - Country:US
Practice Address - Phone:757-340-0361
Practice Address - Fax:757-271-5515
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1213553225100000X
VA2305208496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist