Provider Demographics
NPI:1255350187
Name:FORBES, CECIL ISADORE JR (DC)
Entity type:Individual
Prefix:
First Name:CECIL
Middle Name:ISADORE
Last Name:FORBES
Suffix:JR
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 1:18984 LIVERNOIS AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-4210
Mailing Address - Country:US
Mailing Address - Phone:313-397-1930
Mailing Address - Fax:313-397-1977
Practice Address - Street 1:18984 LIVERNOIS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-4210
Practice Address - Country:US
Practice Address - Phone:313-397-1930
Practice Address - Fax:313-397-1977
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor