Provider Demographics
NPI:1831736941
Name:FOREMAN, ERIN R (ATC, LAT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:R
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MANCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46962-1276
Mailing Address - Country:US
Mailing Address - Phone:260-982-5945
Mailing Address - Fax:
Practice Address - Street 1:604 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:NORTH MANCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46962-1276
Practice Address - Country:US
Practice Address - Phone:260-982-5945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001346A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer