Provider Demographics
NPI:1568513729
Name:FORSYTHE, REBEKAH LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LYNN
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:LYNN
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:15 COURTHOUSE SQUARE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-5351
Practice Address - Country:US
Practice Address - Phone:423-942-8073
Practice Address - Fax:423-942-6660
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist