Individual
FORREST L (BEN) WAIDE
Active
Individual
FORREST L (BEN) WAIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS, CHT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001533
KY
2251H1200X
Hand Physical Therapist
10011030054
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000477215
ANTHEM BCBS FACET #
KY
Enumeration date
10/20/2005
Last updated
02/27/2017
Update your record
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