Provider Demographics
NPI:1740481274
Name:FORBUSH, TRUDY DAVIS (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:DAVIS
Last Name:FORBUSH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 CHINOOK
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8473
Mailing Address - Country:US
Mailing Address - Phone:501-513-9078
Mailing Address - Fax:
Practice Address - Street 1:2425 DAVE WARD DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8686
Practice Address - Country:US
Practice Address - Phone:501-327-1730
Practice Address - Fax:501-327-2340
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2883225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist