Provider Demographics
NPI:1699987511
Name:FORBUSH, STEVEN WAYNE (PT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:WAYNE
Last Name:FORBUSH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 CHINOOK
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8473
Mailing Address - Country:US
Mailing Address - Phone:501-450-5554
Mailing Address - Fax:501-450-5822
Practice Address - Street 1:201 DONAGHEY AVE
Practice Address - Street 2:PHYSICAL THERAPY BUILDING
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72035-5003
Practice Address - Country:US
Practice Address - Phone:501-450-5554
Practice Address - Fax:501-450-5822
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 2879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist