Individual
COREY FORSYTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
28 INGHAM DR, STEVENS, PA 17578-9578
(717) 690-1015
Mailing address
28 INGHAM DR, STEVENS, PA 17578-9578
(717) 690-1015
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PA.0007211
CO
363AS0400X
Surgical Physician Assistant
Primary
PA.0007211
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/28/2021
Last updated
02/15/2022
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