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Individual

MR. JERRY BLAINE FORINASH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.P.T.

Contact information

Practice address
611 WEST VIRGINIA AVE, NUTTER FORT, WV 26301-4460
(304) 669-1971
Mailing address
611 WEST VIRGINIA AVE, NUTTER FORT, WV 26301-4460
(304) 669-1971

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002577
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810006744
WV
Enumeration date
08/24/2006
Last updated
12/27/2010
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