Provider Demographics
NPI:1538304795
Name:FORGING AHEAD THERAPIES, INC.
Entity Type:Organization
Organization Name:FORGING AHEAD THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLTZFUS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:505-281-5431
Mailing Address - Street 1:108 EDELWEISS
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-8055
Mailing Address - Country:US
Mailing Address - Phone:505-281-5431
Mailing Address - Fax:
Practice Address - Street 1:108 EDELWEISS
Practice Address - Street 2:
Practice Address - City:TIJERAS
Practice Address - State:NM
Practice Address - Zip Code:87059-8055
Practice Address - Country:US
Practice Address - Phone:505-281-5431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty