Provider Demographics
NPI:1275292724
Name:FORRESTER, CHERYL LEA (MT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LEA
Last Name:FORRESTER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 NORTHWOODS DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-2377
Mailing Address - Country:US
Mailing Address - Phone:725-577-0153
Mailing Address - Fax:
Practice Address - Street 1:1345 NORTHWOODS DR
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-2377
Practice Address - Country:US
Practice Address - Phone:725-577-0153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO.0024610OtherMASSAGE THERAPIST