Provider Demographics
NPI:1417074782
Name:FOREST INJURY AND REHAB CENTER, INC.
Entity Type:Organization
Organization Name:FOREST INJURY AND REHAB CENTER, INC.
Other - Org Name:DFW INJURY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHADORI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-834-7422
Mailing Address - Street 1:707 N RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76111-4247
Mailing Address - Country:US
Mailing Address - Phone:214-339-9111
Mailing Address - Fax:214-339-9118
Practice Address - Street 1:3420 W ILLINOIS AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-8798
Practice Address - Country:US
Practice Address - Phone:214-339-9111
Practice Address - Fax:214-339-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8940111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty