Provider Demographics
NPI:1275684573
Name:FORBES, KRIS ALAN (PT)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:ALAN
Last Name:FORBES
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:PO BOX 695
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40602-0695
Mailing Address - Country:US
Mailing Address - Phone:502-226-3858
Mailing Address - Fax:502-223-9829
Practice Address - Street 1:1100 GLENSBORO RD STE 1
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-9084
Practice Address - Country:US
Practice Address - Phone:502-839-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY371498135OtherBLUEGRASS FAMILY HEALTH
KY1189025OtherCHA
KY000000368088OtherANTHEM BLUE CROSS
KY7019684OtherAETNA
KY5030401Medicare ID - Type Unspecified