Provider Demographics
NPI:1407442346
Name:FORET, SETH
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:FORET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36240 HIGHWAY 75
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-7703
Mailing Address - Country:US
Mailing Address - Phone:225-407-8917
Mailing Address - Fax:
Practice Address - Street 1:36240 HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-7703
Practice Address - Country:US
Practice Address - Phone:225-407-8917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9284225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist