Provider Demographics
NPI:1083304836
Name:FORSYTHE, ALLISON EDLIN (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:EDLIN
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 ALLISON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-5023
Mailing Address - Country:US
Mailing Address - Phone:502-550-2312
Mailing Address - Fax:
Practice Address - Street 1:2110 ALLISON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-5023
Practice Address - Country:US
Practice Address - Phone:502-550-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015065A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist