Tanner Dean Forrest, ATC

Individual provider Active NPI Athletic Trainer · Fort Scott, KS

NPI 1154885556 · NPPES record last updated May 30, 2019

Key facts

NPI
1154885556
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
2108 Horton St
Fort Scott, KS 66701-3141
Phone
(620) 704-0888
NPI assigned
Jan 30, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

2108 Horton St
Fort Scott, KS 66701-3141

Mailing address

709 N Cayuga St
Frontenac, KS 66763-2072
Phone (620) 704-0888

Other practice location 1

609 E Cherry St
Room 160
Springfield, MO 65807-6580
Phone (620) 704-0888

Other providers in Fort Scott, KS

All providers in Fort Scott, KS · Athletic Trainer in Kansas

Sources for this page

Verify at the official NPI Registry.