Provider Demographics
NPI:1679030746
Name:FORNEY, ERICA LYNNE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LYNNE
Last Name:FORNEY
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 1:3461 DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1975
Mailing Address - Country:US
Mailing Address - Phone:330-261-3057
Mailing Address - Fax:
Practice Address - Street 1:FIZEK FITNESS (ERICAS TOUCH)
Practice Address - Street 2:5555 YOUNGSTOWN WARREN RD
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446
Practice Address - Country:US
Practice Address - Phone:330-261-3057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist