Provider Demographics
NPI:1912252305
Name:FORWE, LORI ANNE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANNE
Last Name:FORWE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-2773
Mailing Address - Country:US
Mailing Address - Phone:501-840-1868
Mailing Address - Fax:
Practice Address - Street 1:14334 HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-7328
Practice Address - Country:US
Practice Address - Phone:501-332-6613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-21
Last Update Date:2012-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist