Provider Demographics
NPI:1982792875
Name:FORWOOD, WALTER ALBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:ALBERT
Last Name:FORWOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:W
Other - Middle Name:ALBERT
Other - Last Name:FORWOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0275
Mailing Address - Country:US
Mailing Address - Phone:302-494-9777
Mailing Address - Fax:302-834-8801
Practice Address - Street 1:510 W ROCKLAND RD
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:DE
Practice Address - Zip Code:19732-2919
Practice Address - Country:US
Practice Address - Phone:302-494-9777
Practice Address - Fax:302-834-8801
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2053546000OtherAMERIHEALTH
DE2053546000OtherPERSONAL CHOICE
DE6469570001OtherPTAN
DE0005106521OtherAETNA
DE00069587000OtherKEYSTONE
DE00069587000OtherKEYSTONE