Provider Demographics
NPI:1417093089
Name:FORSTER, GEORGE A (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:FORSTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37310 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-6959
Mailing Address - Country:US
Mailing Address - Phone:813-782-9564
Mailing Address - Fax:813-783-8513
Practice Address - Street 1:37310 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-6959
Practice Address - Country:US
Practice Address - Phone:813-782-9564
Practice Address - Fax:813-783-8513
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003767111N00000X, 111NN0400X, 111NN1001X, 111NR0200X, 111NR0400X, 111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology
Not Answered111NN1001XChiropractic ProvidersChiropractorNutrition
Not Answered111NR0200XChiropractic ProvidersChiropractorRadiology
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Not Answered111NT0100XChiropractic ProvidersChiropractorThermography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT85890Medicare UPIN