Provider Demographics
NPI:1477842375
Name:FORESTER, MARGARET SHELTON (LMT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:SHELTON
Last Name:FORESTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 WOODHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:LA FAYETTE
Mailing Address - State:GA
Mailing Address - Zip Code:30728-4918
Mailing Address - Country:US
Mailing Address - Phone:423-305-3832
Mailing Address - Fax:
Practice Address - Street 1:1411 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LA FAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728-6435
Practice Address - Country:US
Practice Address - Phone:423-305-3832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6283175F00000X
TN8354175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath