Provider Demographics
NPI:1811183270
Name:FORSYTH, BOBBY JOE (DC)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:JOE
Last Name:FORSYTH
Suffix:
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 1:5288 SPRING MOUNTAIN RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8723
Mailing Address - Country:US
Mailing Address - Phone:702-248-1881
Mailing Address - Fax:702-248-3886
Practice Address - Street 1:5288 SPRING MOUNTAIN RD
Practice Address - Street 2:SUITE 250
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8723
Practice Address - Country:US
Practice Address - Phone:702-248-1881
Practice Address - Fax:702-248-3886
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor