Provider Demographics
NPI:1811976624
Name:KROYER-FORCHE, KATHRYN L (DC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:KROYER-FORCHE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6524 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9431
Mailing Address - Country:US
Mailing Address - Phone:734-568-6910
Mailing Address - Fax:734-568-6912
Practice Address - Street 1:6524 SECOR RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9431
Practice Address - Country:US
Practice Address - Phone:734-568-6910
Practice Address - Fax:734-568-6912
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4612111N00000X
OH1543111N00000X
MI2301007237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYANTHEM BCBSOther000000316327
MIMI6520OtherMI GROUP PROVIDER PTAN
MIMI6520001OtherMI INDIVIDUAL PTAN
MI0C80124OtherBCBS
KY85002897Medicaid
KYU13206Medicare UPIN
MI0C80124OtherBCBS
MIMI6520001OtherMI INDIVIDUAL PTAN